Provider Demographics
NPI:1285394049
Name:NEBRASKA MEDICAL CENTER
Entity type:Organization
Organization Name:NEBRASKA MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SR PHARMACY THIRD PARTY ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:CAVANAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-552-3927
Mailing Address - Street 1:989200 NEBRASKA MEDICAL CTR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68198-9200
Mailing Address - Country:US
Mailing Address - Phone:402-559-5215
Mailing Address - Fax:
Practice Address - Street 1:2232 CHANCELLORS AVE
Practice Address - Street 2:ROOM 1051
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845-2053
Practice Address - Country:US
Practice Address - Phone:308-296-5800
Practice Address - Fax:308-865-2304
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEBRASKA MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-12-21
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy