Provider Demographics
NPI:1154511988
Name:IMMANUEL PERSONAL RESPONSE SYSTEM
Entity Type:Organization
Organization Name:IMMANUEL PERSONAL RESPONSE SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-829-3277
Mailing Address - Street 1:6801 N 67TH PLZ
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68152-2173
Mailing Address - Country:US
Mailing Address - Phone:402-829-3277
Mailing Address - Fax:402-829-3237
Practice Address - Street 1:6801 N 67TH PLZ
Practice Address - Street 2:SUITE 100
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68152-2173
Practice Address - Country:US
Practice Address - Phone:402-829-3277
Practice Address - Fax:402-829-3237
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IMMANUEL RETIREMENT COMMUNITIES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-27
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0537571Medicaid