Organization
NEBRASKA HEART INSTITUTE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARLIN AUSDEMORE (CONTROLLER)
(402) 328-3721
Entity
Organization
Contact information
Practice address
7440 SOUTH 91ST STREET, LINCOLN, NE 68526-9797
(402) 489-6555
(402) 328-3989
Mailing address
PO BOX 82585, LINCOLN, NE 68501-2585
(402) 489-6555
(402) 328-3989
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
207RI0011X
Interventional Cardiology Physician
—
—
2086S0129X
Vascular Surgery Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0537043
—
IA
05
—
20 862808 01
—
KS
Enumeration date
12/21/2005
Last updated
08/11/2008
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