Provider Demographics
NPI:1275876468
Name:CAPITAL MEDICAL CLINIC LLP
Entity Type:Organization
Organization Name:CAPITAL MEDICAL CLINIC LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:CORY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-488-5050
Mailing Address - Street 1:4701 NORMAL BLVD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-5563
Mailing Address - Country:US
Mailing Address - Phone:402-488-5050
Mailing Address - Fax:402-488-5001
Practice Address - Street 1:4701 NORMAL BLVD
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-5563
Practice Address - Country:US
Practice Address - Phone:402-488-5050
Practice Address - Fax:402-488-5001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-05
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty