Provider Demographics
NPI:1366446775
Name:NEBRASKA ORTHOTIC & PROSTHETIC
Entity Type:Organization
Organization Name:NEBRASKA ORTHOTIC & PROSTHETIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERYL
Authorized Official - Middle Name:S
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-493-8288
Mailing Address - Street 1:2845 S 70TH ST
Mailing Address - Street 2:STE 2
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-6821
Mailing Address - Country:US
Mailing Address - Phone:402-489-0077
Mailing Address - Fax:402-489-0090
Practice Address - Street 1:2845 S 70TH ST
Practice Address - Street 2:STE 2
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-6821
Practice Address - Country:US
Practice Address - Phone:402-489-0077
Practice Address - Fax:402-489-0090
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HANGER ORTHOPEDIC GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-06-13
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
NE335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE08968OtherBLUE CROSS/ BLUE SHIELD
NE08968OtherBLUE CROSS/ BLUE SHIELD
NE08968OtherBLUE CROSS/ BLUE SHIELD
NE=========00Medicaid