Provider Demographics
NPI:1801445747
Name:OMAHA JOINT & WELLNESS CARE
Entity type:Organization
Organization Name:OMAHA JOINT & WELLNESS CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TARYN
Authorized Official - Middle Name:
Authorized Official - Last Name:MEHLHOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-550-3228
Mailing Address - Street 1:17021 LAKESIDE HILLS PLZ STE 203
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-2390
Mailing Address - Country:US
Mailing Address - Phone:402-235-4700
Mailing Address - Fax:206-471-6119
Practice Address - Street 1:17021 LAKESIDE HILLS PLZ STE 203
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-2390
Practice Address - Country:US
Practice Address - Phone:402-235-4700
Practice Address - Fax:531-289-2135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-04
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies