# PRIMUS HEALTH CARE PC

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

## Provider details

- **NPI number:** 1508171612
- **Authorized official:** MATTHEW M GLENN MD (OWNER)
- **Authorized official phone:** (402) 421-2100

## Contact information

- **Practice address:** 3900 PINE LAKE RD, LINCOLN, NE 68516-5489
- **Practice address phone:** (402) 421-2100
- **Practice address fax:** (402) 421-2104
- **Mailing address:** 3900 PINE LAKE RD, LINCOLN, NE 68516-5489
- **Mailing address phone:** (402) 421-2100
- **Mailing address fax:** (402) 421-2104

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 08/12/2010
- **Last updated:** 05/22/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 10025898200 | — | NE |
| 05 | — | 10025945200 | — | NE |
| 05 | — | 10025945300 | — | NE |
| 05 | — | 10025945400 | — | NE |
| 05 | — | 10025945500 | — | NE |
| 05 | — | 10025945600 | — | NE |
| 05 | — | 10025945700 | — | NE |
| 05 | — | 10025945800 | — | NE |
| 05 | — | 10025951600 | — | NE |
| 05 | — | 10025951700 | — | NE |
| 05 | — | 10025951800 | — | NE |
| 05 | — | 10025951900 | — | NE |
| 05 | — | 10026136000 | — | NE |
| 05 | — | 10026145100 | — | NE |
| 05 | — | 10026145200 | — | NE |