Provider Demographics
NPI:1316979628
Name:UNIVERSITY OF NEBRASKA BOARD OF REGENTS
Entity type:Organization
Organization Name:UNIVERSITY OF NEBRASKA BOARD OF REGENTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE VICE CHANCELLOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:L
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:402-559-5200
Mailing Address - Street 1:985540 NEBRASKA MEDICAL CTR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68198-5540
Mailing Address - Country:US
Mailing Address - Phone:402-559-8351
Mailing Address - Fax:402-559-3993
Practice Address - Street 1:3902 LEAVENWORTH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68105-1119
Practice Address - Country:US
Practice Address - Phone:402-559-8351
Practice Address - Fax:402-559-3993
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE UNIVERSITY OF NEBRASKA MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-07
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEOP0298OtherEYEMED INSURANCE
NEOP0298OtherEYEMED INSURANCE
NE1316979628Medicare PIN