Provider Demographics
NPI:1558452276
Name:AMBER ENTERPRISES INC
Entity Type:Organization
Organization Name:AMBER ENTERPRISES INC
Other - Org Name:AMBER SPECIALTY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:RINGENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-267-7784
Mailing Address - Street 1:10004 S 152ND ST
Mailing Address - Street 2:STE A
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68138-3930
Mailing Address - Country:US
Mailing Address - Phone:402-896-5000
Mailing Address - Fax:402-896-3774
Practice Address - Street 1:1 E ERIE ST STE 630
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-4756
Practice Address - Country:US
Practice Address - Phone:312-337-7750
Practice Address - Fax:312-337-7760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251F00000X, 332B00000X, 332BP3500X, 3336C0004X, 3336H0001X, 3336S0011X
IL0540186563336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No251F00000XAgenciesHome Infusion
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2023264OtherPK
IL=========002Medicaid
0297920007Medicare NSC