Provider Demographics
NPI:1891576401
Name:SCHROCK MEDICAL CLINIC PC
Entity Type:Organization
Organization Name:SCHROCK MEDICAL CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:C
Authorized Official - Last Name:PRELLWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-236-6499
Mailing Address - Street 1:1616 W 39TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-2922
Mailing Address - Country:US
Mailing Address - Phone:308-236-6499
Mailing Address - Fax:308-236-2050
Practice Address - Street 1:4546 S 86TH ST STE B
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68526-9252
Practice Address - Country:US
Practice Address - Phone:402-817-1999
Practice Address - Fax:402-817-1559
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SCHROCK MEDICAL CLINIC PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty