Provider Demographics
NPI:1821020603
Name:FAMILY HEALTH ASSOCIATES LLC
Entity Type:Organization
Organization Name:FAMILY HEALTH ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-489-4600
Mailing Address - Street 1:1500 S 48TH ST
Mailing Address - Street 2:SUITE 412
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-1225
Mailing Address - Country:US
Mailing Address - Phone:402-489-4600
Mailing Address - Fax:402-489-5151
Practice Address - Street 1:1500 S 48TH ST
Practice Address - Street 2:SUITE 412
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-1225
Practice Address - Country:US
Practice Address - Phone:402-489-4600
Practice Address - Fax:402-489-5151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========13Medicaid
098275Medicare ID - Type UnspecifiedGROUP PROVIDER NUMBER