Provider Demographics
NPI:1508388562
Name:SUNNY MEADOW MEDICAL CLINIC PC
Entity Type:Organization
Organization Name:SUNNY MEADOW MEDICAL CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:GALYEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-370-4100
Mailing Address - Street 1:305 N 37TH ST
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-3275
Mailing Address - Country:US
Mailing Address - Phone:402-370-4100
Mailing Address - Fax:402-370-4101
Practice Address - Street 1:305 N 37TH ST
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-3275
Practice Address - Country:US
Practice Address - Phone:402-370-4100
Practice Address - Fax:402-370-4101
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUNNY MEADOW MEDICAL CLINIC PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-07-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty