Provider Demographics
NPI:1063956571
Name:GREATER NEBRASKA HOME INFUSION INC
Entity type:Organization
Organization Name:GREATER NEBRASKA HOME INFUSION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:LOBEDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-398-4663
Mailing Address - Street 1:2604 SAINT PATRICK AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-1313
Mailing Address - Country:US
Mailing Address - Phone:308-398-4663
Mailing Address - Fax:
Practice Address - Street 1:2604 SAINT PATRICK AVE STE 2
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-1313
Practice Address - Country:US
Practice Address - Phone:308-398-4663
Practice Address - Fax:308-398-4664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-19
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 3336H0001X, 3336S0011X
NE686333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No251E00000XAgenciesHome Health
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2167186OtherPK