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Organization

DIABETIC OUTREACH LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MISS REBECCA JO CAREY CERTIFIED PEDORTHIST (DIRECTOR)
(402) 770-1591
Entity
Organization

Contact information

Practice address
1941 K ST, LINCOLN, NE 68510-1019
(402) 477-1110
(402) 477-1112
Mailing address
1941 K ST, LINCOLN, NE 68510-1019
(402) 477-1110
(402) 477-1112

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
150
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
09871
NEBRASKA BCBS
NE
05
100252587-00
NE
01
5407490001
PTAN
NE
Enumeration date
07/07/2006
Last updated
08/28/2013
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