Provider Demographics
NPI:1538118302
Name:CONSULTANTS IN INFECTIOUS DISEASE LLC
Entity type:Organization
Organization Name:CONSULTANTS IN INFECTIOUS DISEASE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-489-1110
Mailing Address - Street 1:1500 S 48TH ST
Mailing Address - Street 2:SUITE 506
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-1279
Mailing Address - Country:US
Mailing Address - Phone:402-489-1110
Mailing Address - Fax:402-489-8492
Practice Address - Street 1:1500 S 48TH ST
Practice Address - Street 2:SUITE 506
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-1279
Practice Address - Country:US
Practice Address - Phone:402-489-1110
Practice Address - Fax:402-489-8492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-09
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE505846322Medicaid
NE=========13Medicaid