Provider Demographics
NPI:1124029236
Name:MID NEBRASKA MOBILITY, INC.
Entity Type:Organization
Organization Name:MID NEBRASKA MOBILITY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:LANE
Authorized Official - Last Name:ZIMBELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-237-0605
Mailing Address - Street 1:2215 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68847-5346
Mailing Address - Country:US
Mailing Address - Phone:308-237-0605
Mailing Address - Fax:308-237-0608
Practice Address - Street 1:2215 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-5346
Practice Address - Country:US
Practice Address - Phone:308-237-0605
Practice Address - Fax:308-237-0608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-10
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE36998OtherBCBS PROVIDER NUMBER
NE10025156900Medicaid
NE5280760001Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER