Provider Demographics
NPI:1902941289
Name:UNIVERSITY OF NEBRASKA BOARD OF REGENTS
Entity Type:Organization
Organization Name:UNIVERSITY OF NEBRASKA BOARD OF REGENTS
Other - Org Name:UNIVERSITY OF NEBRASKA-LINCOLN, UNIVERSITY HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VC BUSINESS & FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-472-4455
Mailing Address - Street 1:PO BOX 880618
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68588-0618
Mailing Address - Country:US
Mailing Address - Phone:402-472-7435
Mailing Address - Fax:402-472-4593
Practice Address - Street 1:1500 U ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68588
Practice Address - Country:US
Practice Address - Phone:402-472-7488
Practice Address - Fax:402-472-8010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025123700Medicaid
NE10025121400Medicaid
NE10025121300Medicaid
NE099592Medicare PIN