Organization
FAMILY HEALTHCARE OF WAHOO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEO MEDUNA MD, PC (OWNER)
(402) 443-4141
Entity
Organization
Contact information
Practice address
964 N LAUREL ST, WAHOO, NE 68066-1527
(402) 443-4141
(402) 443-4150
Mailing address
964 N LAUREL ST, WAHOO, NE 68066-1527
(402) 443-4141
(402) 443-4150
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CK3490
RAILROAD MEDICARE
NE
Enumeration date
09/02/2006
Last updated
04/20/2008
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