Provider Demographics
NPI:1942333125
Name:PEDIATRIC ANESTHESIA DEPARTMENT
Entity Type:Organization
Organization Name:PEDIATRIC ANESTHESIA DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR - REIMB & MANAGED CARE
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNA
Authorized Official - Suffix:
Authorized Official - Credentials:MPA, MS, FHFMA
Authorized Official - Phone:402-955-6775
Mailing Address - Street 1:PEDIATRIC ANESTHESIA DEPARTMENT
Mailing Address - Street 2:PO BOX 30015
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68103-1115
Mailing Address - Country:US
Mailing Address - Phone:402-955-6928
Mailing Address - Fax:402-955-6900
Practice Address - Street 1:CHILDREN'S HOSPITAL
Practice Address - Street 2:8200 DODGE STREET
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-4113
Practice Address - Country:US
Practice Address - Phone:402-955-6928
Practice Address - Fax:402-955-6900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric AnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025384000Medicaid