1982857595 NPI number — OMAHA CAREONE CAREGIVERS , LLC.

Table of content: GABRIELLE MELISSA POWELL PA (NPI 1639699853)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982857595 NPI number — OMAHA CAREONE CAREGIVERS , LLC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OMAHA CAREONE CAREGIVERS , LLC.
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:
1982857595
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/22/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2507 S 90TH ST
Provider Second Line Business Mailing Address:
SUITE # 6
Provider Business Mailing Address City Name:
OMAHA
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68124-2065
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-504-3219
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2507 S 90TH ST
Provider Second Line Business Practice Location Address:
SUITE # 6
Provider Business Practice Location Address City Name:
OMAHA
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68124-2065
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-504-3219
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/28/2008

Additional Information

Authorized Official

Authorized Official Last Name:
CHIPAKO
Authorized Official First Name:
WATSON
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER / PRESIDENT
Authorized Official Telephone Number:
402-504-3219

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  HHA200804 , 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)





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