Provider Demographics
NPI:1871966184
Name:OSIE, INC.
Entity type:Organization
Organization Name:OSIE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:OSENBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-466-7283
Mailing Address - Street 1:1221 N COTNER BLVD
Mailing Address - Street 2:STE 1
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68505-1879
Mailing Address - Country:US
Mailing Address - Phone:402-466-7283
Mailing Address - Fax:402-466-5387
Practice Address - Street 1:1221 N COTNER BLVD STE 1
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68505-1879
Practice Address - Country:US
Practice Address - Phone:402-466-7283
Practice Address - Fax:402-466-5387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-09
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336C0003X, 3336C0004X, 3336H0001X
NE25903336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2154913OtherPK
2154913OtherPK
NE=========00Medicaid