Provider Demographics
NPI:1477889129
Name:PPA CLINICS LLC
Entity Type:Organization
Organization Name:PPA CLINICS LLC
Other - Org Name:PPA CLINIC FOR GOP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR AND CORPORATE COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:F
Authorized Official - Last Name:ASHFORD
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:402-552-3377
Mailing Address - Street 1:4239 FARNAM ST
Mailing Address - Street 2:#326
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-2868
Mailing Address - Country:US
Mailing Address - Phone:402-552-3377
Mailing Address - Fax:402-552-3266
Practice Address - Street 1:4828 S 24TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68107-2769
Practice Address - Country:US
Practice Address - Phone:402-552-3377
Practice Address - Fax:402-552-3266
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PPA CLINICS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-10-29
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty