Provider Demographics
NPI:1447329941
Name:DARTMED
Entity type:Organization
Organization Name:DARTMED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KAY
Authorized Official - Middle Name:
Authorized Official - Last Name:DARTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-505-3420
Mailing Address - Street 1:16707 Q ST
Mailing Address - Street 2:STE 2C
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68135-1237
Mailing Address - Country:US
Mailing Address - Phone:402-505-3420
Mailing Address - Fax:402-505-3480
Practice Address - Street 1:16707 Q ST
Practice Address - Street 2:SUITE 2C
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68135-1258
Practice Address - Country:US
Practice Address - Phone:402-505-3420
Practice Address - Fax:402-505-3408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE28D2017331291U00000X
NE332B00000X
NE28553336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No291U00000XLaboratoriesClinical Medical Laboratory
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEF249350OtherMIDLANDS CHOICE
NE09857OtherBLUE CROSS BLUE SHIELD
NE10025258900Medicaid
NE290155OtherCOVENTRY
NE========= 68135 0000OtherTRICARE
NE5479260001Medicare NSC