Provider Demographics
NPI:1508843491
Name:NEBRASKA CANCER CARE, LLC
Entity Type:Organization
Organization Name:NEBRASKA CANCER CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHVINI
Authorized Official - Middle Name:
Authorized Official - Last Name:SENGAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-460-5899
Mailing Address - Street 1:815 N KANSAS AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-4470
Mailing Address - Country:US
Mailing Address - Phone:402-460-5899
Mailing Address - Fax:402-460-5619
Practice Address - Street 1:815 N KANSAS AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-4470
Practice Address - Country:US
Practice Address - Phone:402-460-5899
Practice Address - Fax:402-460-5619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-30
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE22433207RH0003X
3336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
No3336C0002XSuppliersPharmacyClinic PharmacyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025373400Medicaid
NE10024998500Medicaid
NE10025512000Medicaid
NE10025486700Medicaid
NE10025458600Medicaid
NE10025458500Medicaid
NE099377Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
NE10025458500Medicaid
DA3078Medicare ID - Type UnspecifiedRAILROAD MEDICARE GROUP