Organization
STATEWIDE MEDICALEQUIPMENT, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLEMENTS U AKARA, MT ASCP (PRESIDENT/CEO)
(402) 697-1985
Entity
Organization
Contact information
Practice address
7511 S 36TH ST, STE 6, BELLEVUE, NE 68147-1244
(402) 697-1985
(402) 738-1985
Mailing address
7511 S 36TH ST, STE 6, BELLEVUE, NE 68147-1244
(402) 697-1985
(402) 738-1985
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
28D1077080
NE
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08871
BLUECROSS BLUESHIELD
NE
05
—
10025079400
—
NE
01
—
F245676
MIDLAND CHOICE
NE
Enumeration date
08/26/2010
Last updated
09/30/2010
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