Provider Demographics
NPI:1134327687
Name:URGENT CARE OF OMAHA MAPLE LLC
Entity Type:Organization
Organization Name:URGENT CARE OF OMAHA MAPLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:HINDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-965-4000
Mailing Address - Street 1:PO BOX 540430
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-0430
Mailing Address - Country:US
Mailing Address - Phone:402-965-4000
Mailing Address - Fax:
Practice Address - Street 1:3830 NORTH 167TH COURT
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68116
Practice Address - Country:US
Practice Address - Phone:402-965-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-06
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025540900Medicaid
NE10025540900Medicaid