Provider Demographics
NPI:1447383948
Name:VISITING NURSE ASSOCIATION OF THE MIDLANDS
Entity Type:Organization
Organization Name:VISITING NURSE ASSOCIATION OF THE MIDLANDS
Other - Org Name:VISITING NURSE ASSOCIATION OF THE MIDLANDS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PHARMACY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:GROTHE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:402-930-4206
Mailing Address - Street 1:12565 W CENTER RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-3802
Mailing Address - Country:US
Mailing Address - Phone:402-930-4206
Mailing Address - Fax:
Practice Address - Street 1:12565 W CENTER RD
Practice Address - Street 2:SUITE 100
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-3810
Practice Address - Country:US
Practice Address - Phone:402-930-4206
Practice Address - Fax:402-344-6527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2146251F00000X
NE2820332BP3500X, 3336C0003X, 3336L0003X, 3336S0011X
IA31003336C0003X
3336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE251F00000XMedicaid