Organization
TENNA SHU PALACE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYRONE V HAYES (OWNER)
(402) 215-3822
Entity
Organization
Contact information
Practice address
1822 N 33RD ST, OMAHA, NE 68111-4108
(402) 215-3822
Mailing address
1822 N 33RD ST, OMAHA, NE 68111-4108
(402) 215-3822
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
09/18/2019
Last updated
09/18/2019
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