Provider Demographics
NPI:1144465352
Name:ORTHO MEDICS OMAHA
Entity type:Organization
Organization Name:ORTHO MEDICS OMAHA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KASSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARNDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-614-7321
Mailing Address - Street 1:6601 S 118TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-3584
Mailing Address - Country:US
Mailing Address - Phone:402-614-7321
Mailing Address - Fax:402-614-8277
Practice Address - Street 1:6601 S 118TH ST STE 100
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-3584
Practice Address - Country:US
Practice Address - Phone:402-614-7321
Practice Address - Fax:402-614-8277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-03
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
40023OtherBC/BS
NONEOtherTRI CARE
NE10025827200Medicaid
IA1144465352Medicaid
NE10025827200Medicaid
IA1144465352Medicaid