| Ponca Tribe Of Nebraska | |
|
2602 J St Omaha NE 68107-1643 | |
| (402) 733-3612 | |
| (402) 734-7156 |
| Full Name | Ponca Tribe Of Nebraska |
|---|---|
| Speciality | Clinic/Center |
| Location | 2602 J St, Omaha, Nebraska |
| Authorized Official Name and Position | Kathleen M Rieb (COMPLIANCE OFFICER) |
| Authorized Official Contact | 4023152772 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ponca Tribe Of Nebraska 5805 S 86th Cir Omaha NE 68127-4145 Ph: (402) 315-2760 | Ponca Tribe Of Nebraska 2602 J St Omaha NE 68107-1643 Ph: (402) 733-3612 |
| NPI Number | 1710172879 |
|---|---|
| Provider Enumeration Date | 09/12/2007 |
| Last Update Date | 10/22/2018 |
| Medicare PECOS PAC ID | 0648169177 |
|---|---|
| Medicare Enrollment ID | O20190227000629 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710172879 | NPI | - | NPPES |
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