Provider Demographics
NPI:1902837917
Name:ONE WORLD COMMUNITY HEALTH CENTERS INC.
Entity Type:Organization
Organization Name:ONE WORLD COMMUNITY HEALTH CENTERS INC.
Other - Org Name:ONE WORLD PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SKOLKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-502-8842
Mailing Address - Street 1:4920 SOUTH 30TH STREET
Mailing Address - Street 2:STE 103
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68107-1656
Mailing Address - Country:US
Mailing Address - Phone:402-502-5832
Mailing Address - Fax:402-502-5841
Practice Address - Street 1:4920 S 30TH ST
Practice Address - Street 2:STE 103
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68107-1590
Practice Address - Country:US
Practice Address - Phone:402-502-5832
Practice Address - Fax:402-502-5841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2660333600000X
NE402333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025308800Medicaid