Provider Demographics
NPI:1881925022
Name:CANCER PARTNERS OF NEBRASKA PC
Entity type:Organization
Organization Name:CANCER PARTNERS OF NEBRASKA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROUSEK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:402-420-7000
Mailing Address - Street 1:4101 TIGER LILY RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-5587
Mailing Address - Country:US
Mailing Address - Phone:402-420-7000
Mailing Address - Fax:402-420-6969
Practice Address - Street 1:4101 TIGER LILY RD STE 100
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-5587
Practice Address - Country:US
Practice Address - Phone:402-420-7000
Practice Address - Fax:402-420-6969
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CANCER PARTNERS OF NEBRASKA PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-01-28
Last Update Date:2024-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835X0200XPharmacy Service ProvidersPharmacistOncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
2817914OtherNCPDP
NE10025835300Medicaid
1310070002Medicare NSC