Provider Demographics
NPI:1417157116
Name:CREIGHTON UNIVERSITY
Entity Type:Organization
Organization Name:CREIGHTON UNIVERSITY
Other - Org Name:CREIGHTON UNIVERSITY SLEEP LAB
Other - Org Type:Other Name
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:BURKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-280-2131
Mailing Address - Street 1:PO BOX 2500
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68178-0001
Mailing Address - Country:US
Mailing Address - Phone:402-280-2700
Mailing Address - Fax:
Practice Address - Street 1:3006 WEBSTER ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-2027
Practice Address - Country:US
Practice Address - Phone:402-449-4486
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CREIGHTON UNIVERSITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-20
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies