Provider Demographics
NPI:1962465062
Name:STRAUB MEDICAL SUPPLY INC
Entity Type:Organization
Organization Name:STRAUB MEDICAL SUPPLY INC
Other - Org Name:JIM'S HOME HEALTH SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:D
Authorized Official - Middle Name:LEHN
Authorized Official - Last Name:STRAUB
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:402-420-5241
Mailing Address - Street 1:1400 N 48TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68504-3170
Mailing Address - Country:US
Mailing Address - Phone:402-465-9000
Mailing Address - Fax:402-465-9015
Practice Address - Street 1:1400 N 48TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68504-3170
Practice Address - Country:US
Practice Address - Phone:402-465-9000
Practice Address - Fax:402-465-9015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-10
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
9940OtherBLUE CROSS BLUE SHIELD
F916OtherMIDLANDS CHOICE
NE=========01Medicaid
NE=========01Medicaid