Provider Demographics
NPI:1952977456
Name:NEBRASKA REGENERATIVE HEALTHCARE LLC
Entity Type:Organization
Organization Name:NEBRASKA REGENERATIVE HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:W
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:2021-06-03
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service