# CHENEY RIDGE FAMILY MEDICAL CLINIC, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003044660
- **Authorized official:** PATRICK J BERTOLINI (PRESIDENT)
- **Authorized official phone:** (402) 420-7113

## Contact information

- **Practice address:** 3540 VILLAGE DR, SUITE 100, LINCOLN, NE 68516-4706
- **Practice address phone:** (402) 420-7113
- **Mailing address:** 3540 VILLAGE DR, SUITE 100, LINCOLN, NE 68516-4706
- **Mailing address phone:** (402) 420-7113

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 16656 | NE | Yes |

## Other

- **Enumeration date:** 06/22/2009
- **Last updated:** 05/18/2020