Organization
PTI-NPS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY EHLE (CLINICAL AUTHORIZATIONS COORDINATOR)
(800) 546-5677
Entity
Organization
Contact information
Practice address
13660 CALIFORNIA ST, OMAHA, NE 68154-5233
(800) 546-5677
Mailing address
13660 CALIFORNIA ST, OMAHA, NE 68154-5233
(800) 546-5677
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
13263
NE
Other
Enumeration date
10/18/2016
Last updated
10/18/2016
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