# WESTERN NEBRASKA UROLOGY LLC

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

## Provider details

- **NPI number:** 1720162993
- **Authorized official:** SHAWN MICHAEL ACINO MD PACS (PRESIDENT)
- **Authorized official phone:** (308) 630-2450

## Contact information

- **Practice address:** 2 WEST 42ND STREET, SUITE 3600, SCOTTSBLUFF, NE 69361
- **Practice address phone:** (308) 630-2450
- **Practice address fax:** (308) 630-2492
- **Mailing address:** 2 WEST 42ND STREET, SUITE 3600, SCOTTSBLUFF, NE 69361
- **Mailing address phone:** (308) 630-2450
- **Mailing address fax:** (308) 630-2492

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | 22723 | IL | Yes |

## Other

- **Enumeration date:** 10/24/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 07283 | BLUE CROSS | NE |
| 05 | — | 10025264700 | — | NE |
| 01 | — | 241716 | MIDLANDS CHOICE | — |
| 01 | — | DD6108 | RR MCARE | — |