Provider Demographics
NPI:1508833310
Name:PHYSICIANS CHOICE NEBRASKA LLC
Entity Type:Organization
Organization Name:PHYSICIANS CHOICE NEBRASKA LLC
Other - Org Name:PHYSICIANS CHOICE HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TIM
Authorized Official - Middle Name:A
Authorized Official - Last Name:MANION
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-827-7802
Mailing Address - Street 1:8212 F ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68127-1740
Mailing Address - Country:US
Mailing Address - Phone:402-331-2273
Mailing Address - Fax:402-933-4255
Practice Address - Street 1:8212 F ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127-1740
Practice Address - Country:US
Practice Address - Phone:402-331-2273
Practice Address - Fax:402-933-4255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-01
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEHHA1047251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025324300Medicaid
NE287128Medicare ID - Type UnspecifiedHOME HEALTH CARE