Provider Demographics
NPI:1669706289
Name:SCHOLLMEYER FAMILY CHIROPRACTIC, PC
Entity type:Organization
Organization Name:SCHOLLMEYER FAMILY CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHOLLMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-721-5500
Mailing Address - Street 1:2415 E 23RD AVE S STE 200
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68025-2423
Mailing Address - Country:US
Mailing Address - Phone:402-721-5500
Mailing Address - Fax:
Practice Address - Street 1:2415 E 23RD AVE S STE 200
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-2423
Practice Address - Country:US
Practice Address - Phone:402-721-5500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-29
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1160111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U52489Medicare UPIN
268548Medicare PIN