LAKESIDE ORTHOPEDICS PC NPI 1508058835

NPI Information

NPI: 1508058835
Provider Name: LAKESIDE ORTHOPEDICS PC
Classification: Durable Medical Equipment & Medical Supplies - 332BC3200X
Entity Type: Organization

Specialization: Customized Equipment

Address:
1413 SOUTH WASHINTON
SUITE 200
PAPILLION, NE
ZIP 68046
Phone: (402) 758-5690
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LAKESIDE ORTHOPEDICS PC is a customized equipment durable medical equipment medical supplies in Papillion, NE. LAKESIDE ORTHOPEDICS PC NPI is 1508058835. The provider is registered as an organization entity type.

The provider's business location address is:

1413 SOUTH WASHINTON
SUITE 200
PAPILLION, NE
ZIP 68046
Phone: (402) 758-5690
Fax: (402) 758-5699

The provider's authorized official is Nancy J. Mickelson .
The authorized official title is Office Manager and has the following contact phone number (402) 758-5690.

The enumeration date for this NPI number is 8/10/2007 and was last updated on 11/15/2007.

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	332BC3200X	Durable Medical Equipment & Medical Supplies	Customized Equipment		NEBRASKA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	099864	MEDICARE OSCAR/CERTIFICATION	NEBRASKA
2	5944190001	MEDICARE NSC	NEBRASKA
3	10025497200	MEDICAID	NEBRASKA

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

NPI Synchronization or Removal

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