Ageless Men'S Health Series II Ne LLC
Family Medicine, Adult Medicine in Lincoln, NE. Organization (NPI-2).
NPI number1699396150
StatusActive
Last updated in NPPESNov 21, 2023
Details
- NPI
- 1699396150
- Entity type
- Organization (NPI-2)
- Legal business name
- Ageless Men'S Health Series II Ne LLC
- Organization subpart
- No
- Enumeration date
- May 6, 2020
- Certification date
- Nov 21, 2023
- Last updated
- Nov 21, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207QA0505X | Family Medicine, Adult Medicine | – | – | Yes |
| 207Q00000X | Family Medicine | – | – | |
| 261QP2300X | Clinic/Center, Primary Care | – | – |
Other names
- Ageless Men'S Health (Doing Business As)
Practice location
5715 S 34th St Ste 400Lincoln, NE 68516-6648
Phone 901-757-3643
Mailing address
5715 S 34th St Ste 400Lincoln, NE 68516-6648
Other practice locations
14473 W Center Rd
Omaha, NE 68144-5401
Omaha, NE 68144-5401
Phone 702-243-0028
Authorized official
Teah Michelle Smith
Credentialing Manager
9012053999
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