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Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. BEVERLY PHILLIPS OTRL, CAPS (PRESIDENT)
(402) 291-9514
Entity
Organization

Contact information

Practice address
7914 W DODGE RD # 326, OMAHA, NE 68114-3417
(402) 291-9514
(402) 291-4202
Mailing address
7914 W DODGE RD # 326, OMAHA, NE 68114-3417
(402) 291-9514
(402) 291-4202

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10025825900
NE
Enumeration date
03/03/2011
Last updated
03/03/2011
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