IVY STREET MEDICAL LLC NPI 1487806147

NPI Information

NPI: 1487806147
Provider Name: IVY STREET MEDICAL LLC
Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
902 IVY ST
STANTON, NE
ZIP 68779
Phone: (402) 439-5500
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IVY STREET MEDICAL LLC is a rural health clinic center in Stanton, NE. IVY STREET MEDICAL LLC NPI is 1487806147. The provider is registered as an organization entity type.

The provider's business location address is:

902 IVY ST
STANTON, NE
ZIP 68779-348
Phone: (402) 439-5500
Fax: (402) 439-5502

The provider's authorized official is Karla E Damgaard .
The authorized official title is Owner and has the following contact phone number (402) 439-5500.

The enumeration date for this NPI number is 10/14/2008 and was last updated on 10/14/2008.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR1300X	Clinic/Center	Rural Health			Yes

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: 5/5/2024

NPI Synchronization or Removal

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