Provider Demographics
NPI:1063720084
Name:JOSHUA MEDICAL CENTERS LLC
Entity type:Organization
Organization Name:JOSHUA MEDICAL CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:KERSHNER
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:302-715-1827
Mailing Address - Street 1:PO BOX 7365
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68107-2715
Mailing Address - Country:US
Mailing Address - Phone:302-715-1827
Mailing Address - Fax:
Practice Address - Street 1:2429 M ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68107-2715
Practice Address - Country:US
Practice Address - Phone:402-731-7333
Practice Address - Fax:402-614-5405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-24
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026076500Medicaid