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
Update your record
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