MADONNA REHABILITATION HOSPITAL
Clinical Neuropsychologist
Lincoln, Nebraska
Provider NPI: 1417045642
Organization Information:Organization Name: MADONNA REHABILITATION HOSPITAL
Organization is Subpart
Authorized Official: PAUL A DONGILLI PRESIDENT & CEO 402-4133000
Practice Location:
5401 SOUTH ST LINCOLN, NE 68506 US
Tel: 402-413-3000 Fax: 402-413-4113
Business Mailing Address:
5401 SOUTH ST LINCOLN, NE 68506 US
Tel: 402-413-3000 Fax: 402-413-4113
Entity Type: Organization
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Organization is Subpart
Authorized Official: PAUL A DONGILLI PRESIDENT & CEO 402-4133000
Practice Location:
5401 SOUTH ST LINCOLN, NE 68506 US
Tel: 402-413-3000 Fax: 402-413-4113
Business Mailing Address:
5401 SOUTH ST LINCOLN, NE 68506 US
Tel: 402-413-3000 Fax: 402-413-4113
Entity Type: Organization
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 208100000X | Physicians Physical Medicine & Rehabilitation |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
MEDICAID | 0982017 | IA | 01 |
BLUE CROSS | 7729 | NE | 01 |
MEDICAID | 500885900 | MO | 01 |
RAILROAD MEDICARE | D0287 | 01 | |
MEDICAID | 100187780D | KS | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
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