1437710043 NPI number — CHILDREN'S PHYSICIANS

Table of content: (NPI 1437710043)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437710043 NPI number — CHILDREN'S PHYSICIANS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHILDREN'S PHYSICIANS
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:
1437710043
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/25/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 247037
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:
68124-7037
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-955-6935
Provider Business Mailing Address Fax Number:
402-955-6931

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8200 DODGE ST
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:
68114-4113
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-955-6935
Provider Business Practice Location Address Fax Number:
402-955-6931
Provider Enumeration Date:
06/25/2019

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
STEVENS
Authorized Official First Name:
SARAH
Authorized Official Middle Name:
J
Authorized Official Title or Position:
DIRECTOR OF FINANCE
Authorized Official Telephone Number:
402-955-6587

Provider Taxonomy Codes

  • Taxonomy code: 208000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LP0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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