Provider Demographics
NPI:1528356912
Name:CHRISTENSEN AUDIOLOGY & HEARING AID CENTER LLC
Entity Type:Organization
Organization Name:CHRISTENSEN AUDIOLOGY & HEARING AID CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ROY
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:402-489-3450
Mailing Address - Street 1:7700 A ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-4206
Mailing Address - Country:US
Mailing Address - Phone:402-489-3450
Mailing Address - Fax:402-489-3452
Practice Address - Street 1:1420 N. 10TH
Practice Address - Street 2:
Practice Address - City:NEBRASKA CITY
Practice Address - State:NE
Practice Address - Zip Code:68410-1236
Practice Address - Country:US
Practice Address - Phone:402-489-3450
Practice Address - Fax:402-489-3452
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHRISTENSEN AUDIOLOGY & HEARING AID CENTER LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-07-19
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE172237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025727100Medicaid
NE10025753500Medicaid