Provider Demographics
NPI:1124423330
Name:TERYL CORP
Entity type:Organization
Organization Name:TERYL CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-697-7537
Mailing Address - Street 1:13304 W CENTER RD
Mailing Address - Street 2:SUITE 225
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-3453
Mailing Address - Country:US
Mailing Address - Phone:402-697-7536
Mailing Address - Fax:402-614-7579
Practice Address - Street 1:13304 W CENTER RD
Practice Address - Street 2:SUITE 225
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-3453
Practice Address - Country:US
Practice Address - Phone:402-697-7536
Practice Address - Fax:402-614-7579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-30
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEHHA1007251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health