Provider Demographics
NPI:1679547491
Name:FAMILY MEDICINE ASSOCIATES MILLARD-GRETNA, P C
Entity Type:Organization
Organization Name:FAMILY MEDICINE ASSOCIATES MILLARD-GRETNA, P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:SAVINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-896-1242
Mailing Address - Street 1:17241 OAK DRIVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-2202
Mailing Address - Country:US
Mailing Address - Phone:402-896-1242
Mailing Address - Fax:402-896-8948
Practice Address - Street 1:17241 OAK DRIVE
Practice Address - Street 2:SUITE 101
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-2202
Practice Address - Country:US
Practice Address - Phone:402-896-1242
Practice Address - Fax:402-896-8948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-16
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
092159Medicare UPIN