Provider Demographics
NPI:1437773777
Name:GREATER NEBRASKA INFUSION CENTER, INC.
Entity Type:Organization
Organization Name:GREATER NEBRASKA INFUSION CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:LOBEDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-675-7016
Mailing Address - Street 1:2604 SAINT PATRICK AVE STE 6
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-1313
Mailing Address - Country:US
Mailing Address - Phone:308-675-7016
Mailing Address - Fax:308-675-7017
Practice Address - Street 1:2604 SAINT PATRICK AVE STE 6
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-1313
Practice Address - Country:US
Practice Address - Phone:308-675-7016
Practice Address - Fax:308-675-7017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-02
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0002XSuppliersPharmacyClinic PharmacyGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty