Provider Demographics
NPI:1922735406
Name:HYDR8, LLC
Entity Type:Organization
Organization Name:HYDR8, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MERTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-926-9637
Mailing Address - Street 1:PO BOX 815
Mailing Address - Street 2:
Mailing Address - City:BOYS TOWN
Mailing Address - State:NE
Mailing Address - Zip Code:68010-0815
Mailing Address - Country:US
Mailing Address - Phone:402-926-9637
Mailing Address - Fax:402-895-2036
Practice Address - Street 1:18210 WRIGHT ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-2883
Practice Address - Country:US
Practice Address - Phone:402-926-9637
Practice Address - Fax:402-895-2036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-04
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care