Provider Demographics
NPI:1437513264
Name:BEYOND CARE PEDIATRICS LLC
Entity Type:Organization
Organization Name:BEYOND CARE PEDIATRICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:W
Authorized Official - Last Name:DOUGLAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:531-600-6281
Mailing Address - Street 1:16945 FRANCES ST STE 200B
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-2312
Mailing Address - Country:US
Mailing Address - Phone:531-600-6281
Mailing Address - Fax:531-600-6282
Practice Address - Street 1:16945 FRANCES ST STE 200B
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-2312
Practice Address - Country:US
Practice Address - Phone:531-600-6281
Practice Address - Fax:531-600-6282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-07
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty