Provider Demographics
NPI:1134597495
Name:RUGH, GREG
Entity type:Individual
Prefix:
First Name:GREG
Middle Name:
Last Name:RUGH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 S 70TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-4293
Mailing Address - Country:US
Mailing Address - Phone:402-486-3410
Mailing Address - Fax:402-486-3356
Practice Address - Street 1:1101 S 70TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-4293
Practice Address - Country:US
Practice Address - Phone:402-486-3410
Practice Address - Fax:402-486-3356
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-03
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic