Organization
WESTERN NEBRASKA UROLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN MICHAEL ACINO MD PACS (PRESIDENT)
(308) 630-2450
Entity
Organization
Contact information
Practice address
2 WEST 42ND STREET, SUITE 3600, SCOTTSBLUFF, NE 69361
(308) 630-2450
(308) 630-2492
Mailing address
2 WEST 42ND STREET, SUITE 3600, SCOTTSBLUFF, NE 69361
(308) 630-2450
(308) 630-2492
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
22723
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07283
BLUE CROSS
NE
05
—
10025264700
—
NE
01
—
241716
MIDLANDS CHOICE
—
01
—
DD6108
RR MCARE
—
Enumeration date
10/24/2006
Last updated
08/22/2020
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