Organization
CHILDREN'S HOSPITAL & MEDICAL CENTER
Active
Organization
CHILDREN'S HOSPITAL & MEDICAL CENTER
Active
Other names
Children's Nebraska Outpatient Surgery Center, Children's Hospital & Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
CHANDA C CHACON (PRESIDENT & CEO)
(402) 955-4106
Entity
Organization
Contact information
Practice address
110 N 175TH ST STE 1600, OMAHA, NE 68118-3581
(402) 955-5437
Mailing address
8200 DODGE ST, OMAHA, NE 68114-4113
(402) 955-5400
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
NE
Enumeration date
04/11/2016
Last updated
10/02/2023
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