Organization
PRIMARY CARE PHYSICIANS, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORDEN BAZAR (BUSINESS ADMINISTRATOR)
(402) 330-1414
Entity
Organization
Contact information
Practice address
12728 AUGUSTA AVE, OMAHA, NE 68144-3754
(402) 330-1410
(402) 330-4294
Mailing address
12728 AUGUSTA AVE, OMAHA, NE 68144-3754
(402) 330-1410
(402) 330-7139
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0550764
—
IA
01
—
28D0454559
CLIA ID NUMBER
—
Enumeration date
03/24/2006
Last updated
01/23/2025
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