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DSH280013B THE NEBRASKA MEDICAL CENTER (Terminated)
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Main Details
Name
THE NEBRASKA MEDICAL CENTER
Subdivision Name
UNIVERSITY HOSPITAL-CLINICAL CANCER CTR
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH280013B
Medicare Provider Number
280013
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
9/8/2007
Participating Start Date
4/1/1995
Participating Approval Date
9/10/2007
Last Recertification Date
9/5/2018
Termination Date
Termination Reason
7/1/2019
Outpatient facility moved within the 4 walls of the parent hospital
Contacts
Authorizing Official
Nebraska Medical Center
Stephanie Daubert, CFO
(402) 552-2889
Primary Contact
Nebraska Medicine
BILL BARNES, BUSINESS DIRECTOR, PHARMACY
(402) 559-9537
Addresses
Street Address
989200 NEBRASKA MEDICAL CENTER
OMAHA, NE 68198
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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12/10/09 UPDATED ADDR (WAS 600 SOUTH 42ND STREET) 10/8/09 UPDATED ENTITY NAME (WAS UNIVERSITY OF NEBRASKA MEDICAL CENTER)12/16/10 ADDED MEDICAID#(911858433-02)
12/16/2010
June 2025
June 2025
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