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DSH280013BF THE NEBRASKA MEDICAL CENTER (Terminated)
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Main Details
Name
THE NEBRASKA MEDICAL CENTER
Subdivision Name
Clarkson Family Medicine - Clarkson Family Medicine - ICC
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH280013BF
Medicare Provider Number
280013
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/9/2019
Participating Start Date
7/1/2019
Participating Approval Date
4/19/2019
Last Recertification Date
9/8/2022
Termination Date
Termination Reason
4/1/2023
Site closure
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
1319 Leavenworth Street
Omaha, NE 68102
Billing Address
Nebraska Medical Center
989200 Nebraska Medical Center
Omaha, NE 68198
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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