Provider Demographics
NPI:1568494524
Name:MICHAELS MEDICAL INC
Entity Type:Organization
Organization Name:MICHAELS MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHLEPPENBACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-488-3411
Mailing Address - Street 1:4818 FIR HOLLOW LN
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-5314
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4720 PRESCOTT AVE
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-5455
Practice Address - Country:US
Practice Address - Phone:402-488-3411
Practice Address - Fax:402-488-6535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0542951Medicaid
NE08961OtherBLUE CROSS BLUE SHIELD
IA0542951Medicaid
NE1197630001Medicare ID - Type Unspecified