Provider Demographics
NPI:1407185143
Name:ZUTAN HOME HEALTHCARE, INC.
Entity Type:Organization
Organization Name:ZUTAN HOME HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AUGUSTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANYAEGBUNAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-917-3406
Mailing Address - Street 1:9529 SPRAGUE ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134-3840
Mailing Address - Country:US
Mailing Address - Phone:402-917-3406
Mailing Address - Fax:402-884-1188
Practice Address - Street 1:9529 SPRAGUE ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68134-3840
Practice Address - Country:US
Practice Address - Phone:402-504-3326
Practice Address - Fax:402-884-1188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-08
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEHHA200803251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEHHA200803OtherSTATE LICENSE NUMBER
NE287139Medicare PIN