Provider Demographics
NPI:1871599142
Name:NEBRASKA ORTHOTIC & PROSTHETIC
Entity type:Organization
Organization Name:NEBRASKA ORTHOTIC & PROSTHETIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERYL
Authorized Official - Middle Name:S
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-493-8288
Mailing Address - Street 1:722 N DIERS AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-4954
Mailing Address - Country:US
Mailing Address - Phone:308-398-2242
Mailing Address - Fax:308-398-2239
Practice Address - Street 1:710 N DIERS AVE
Practice Address - Street 2:STE 0
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-4976
Practice Address - Country:US
Practice Address - Phone:308-398-2242
Practice Address - Fax:308-398-2239
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HANGER ORTHOPEDIC GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-06-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE08968OtherBCBS
NE=========01Medicaid
NE3962680001Medicare ID - Type Unspecified