| Pine Lake Health Llc | |
|
13220 Callum Dr Ste 4 Waverly NE 68462-2561 | |
| (402) 786-5563 | |
| (402) 423-4201 |
| Full Name | Pine Lake Health Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 13220 Callum Dr, Waverly, Nebraska |
| Authorized Official Name and Position | Matthew M Glenn (PHYSICIAN) |
| Authorized Official Contact | 4024234200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pine Lake Health Llc 2611 S 70th St Lincoln NE 68506-2960 Ph: (402) 423-4200 | Pine Lake Health Llc 13220 Callum Dr Ste 4 Waverly NE 68462-2561 Ph: (402) 786-5563 |
| NPI Number | 1780814475 |
|---|---|
| Provider Enumeration Date | 07/16/2009 |
| Last Update Date | 08/30/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780814475 | NPI | - | NPPES |
| 10025748100 | Medicaid | NE |
Family Medicine And Urgent Care Of Waverly, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 13851 Guildford St Ste D, Waverly, NE 68462 Phone: 402-786-7425 Fax: 402-786-7427 |