Provider Demographics
NPI:1356615959
Name:OMAHA MEDICAL SUPPLIES, LLC
Entity type:Organization
Organization Name:OMAHA MEDICAL SUPPLIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NDUMU
Authorized Official - Middle Name:ANUH
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-556-9053
Mailing Address - Street 1:6013 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68104-4103
Mailing Address - Country:US
Mailing Address - Phone:402-556-9053
Mailing Address - Fax:402-556-5204
Practice Address - Street 1:6013 MAPLE ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68104-4103
Practice Address - Country:US
Practice Address - Phone:402-556-9053
Practice Address - Fax:402-556-5204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-28
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE470816921332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies