1285901439 NPI number — G G ENTERPRISES INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285901439 NPI number — G G ENTERPRISES INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
G G ENTERPRISES INC.
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:
Provider Other Organization Name Type Code:
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:
1285901439
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/08/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10040 REGENCY CIR STE 250
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OMAHA
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68114-3738
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-393-5432
Provider Business Mailing Address Fax Number:
402-393-0220

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10040 REGENCY CIR STE 250
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OMAHA
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68114-3738
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-393-5432
Provider Business Practice Location Address Fax Number:
402-393-0220
Provider Enumeration Date:
11/16/2011

Additional Information

Authorized Official

Authorized Official Last Name:
GARD
Authorized Official First Name:
GARY
Authorized Official Middle Name:
C
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
402-393-5432

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  181 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 08430 . This is a "BC/BS" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 273852 . This is a "MEDICARE PART B CARRIER" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 103230 . This is a "MHN" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 4786 . This is a "MIDLANDS CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 048369 . This is a "VALUE OPTIONS" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".




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