Provider Demographics
NPI:1851681258
Name:GW & PE INCORP.
Entity Type:Organization
Organization Name:GW & PE INCORP.
Other - Org Name:PAYNE'S HEARING PROFESSIONALS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEARING AID DISPENSER
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:HEARING AID DISPENSE
Authorized Official - Phone:1402-721-9213
Mailing Address - Street 1:849 E 23RD ST
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68025-2444
Mailing Address - Country:US
Mailing Address - Phone:140-272-1921
Mailing Address - Fax:
Practice Address - Street 1:849 E 23RD ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-2444
Practice Address - Country:US
Practice Address - Phone:140-272-1921
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-19
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE580332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE100257142-00Medicaid