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DSH280013AR THE NEBRASKA MEDICAL CENTER (Terminated)
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Main Details
Name
THE NEBRASKA MEDICAL CENTER
Subdivision Name
Elkhorn Clinic - Immediate Care Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH280013AR
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
Termination Date
Termination Reason
10/1/2019
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
20310 Blue Sage Parkway
Omaha, NE 68130
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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