Provider Demographics
NPI:1831397751
Name:HUSKER OCCUPATIONAL MEDICINE
Entity type:Organization
Organization Name:HUSKER OCCUPATIONAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMI
Authorized Official - Middle Name:
Authorized Official - Last Name:RIHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-352-0653
Mailing Address - Street 1:500 W BROADWAY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51503-0842
Mailing Address - Country:US
Mailing Address - Phone:712-352-0653
Mailing Address - Fax:712-352-0656
Practice Address - Street 1:500 W BROADWAY
Practice Address - Street 2:SUITE 201
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503-0842
Practice Address - Country:US
Practice Address - Phone:712-352-0653
Practice Address - Fax:712-352-0656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA-117058363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty