St Croix Nebraska Sip Llc
Hospice and Palliative Medicine (Internal Medicine) Physician in Omaha, NE(View on Map)
Legal Business Name
St Croix Nebraska Sip Llc
NPI Number
1881284602
NPI Type
Organization
Enumeration Date
01/25/2021
Specialties
(Taxonomies)Name
Code
207RH0002X
163WC0400X
171M00000X
164W00000X
363L00000X
Primary Taxonomy
Yes
No
No
No
No
Contact
Information
Purpose
Mailing
Location
Address
1065 N 115TH ST STE 120
1065 N 115TH ST STE 120
City
Omaha
Omaha
State
NE
NE
Postal Code
68154-4423
68154-4423
Country
US
US
Telephone Number
(402) 609-4818
(402) 609-4818
Authorized Official
Name
Kimberly Olson
Title or Position
CHIEF COMPLIANCE OFFICER
Telephone Number
(651) 237-9716
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 01/25/2021
Provider Address
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