1326295494 NPI number — THE PHYSICIAN NETWORK

Table of content: (NPI 1326295494)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326295494 NPI number — THE PHYSICIAN NETWORK

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE PHYSICIAN NETWORK
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SAINT ELIZABETH SPORTS & PHYSICAL THERAPY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326295494
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8055 O ST
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
LINCOLN
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68510-2564
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-421-0896
Provider Business Mailing Address Fax Number:
402-421-0945

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1601 N 86TH ST
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
LINCOLN
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68505-3713
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-327-7515
Provider Business Practice Location Address Fax Number:
402-327-7516
Provider Enumeration Date:
08/20/2008

Additional Information

Authorized Official

Authorized Official Last Name:
RECKEWEY
Authorized Official First Name:
REX
Authorized Official Middle Name:
K
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
402-421-0896

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332BC3200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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