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MIRACLE HILLS PRIMARY CARE CENTER PC NPI 1104292093


NPI Information

NPI: 1104292093
Provider Name: MIRACLE HILLS PRIMARY CARE CENTER PC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 28D1009451

Address:
11819 MIRACLE HILLS DR STE 105
OMAHA, NE
ZIP 68154
Phone: (402) 905-2075
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MIRACLE HILLS PRIMARY CARE CENTER PC is a family medicine in Omaha, NE. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. MIRACLE HILLS PRIMARY CARE CENTER PC NPI is 1104292093. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

11819 MIRACLE HILLS DR STE 105
OMAHA, NE
ZIP 68154-428
Phone: (402) 905-2075
Fax: (402) 905-9864

The provider's authorized official is Maman L Ali .
The authorized official title is President and has the following contact phone number (402) 905-2075.

The CLIA number assigned to this NPI record is 28D1009451 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/14/2015 and was last updated on 8/14/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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