NPIMap

Organization Active NPI

Northeast Nebraska LTC, LLC

  • Long Term Care Pharmacy
  • Norfolk, NE
National Provider Identifier
1033502950
Registry record updated Mar 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
605 Issued in NE
Legal business name
NORTHEAST NEBRASKA LTC, LLC
Practice address
120 N 27TH St
Suite 200
Norfolk, NE 68701-3286
Phone
(402) 371-3444
Fax
(402) 371-3566
NPI assigned
Mar 17, 2015
Last updated
Mar 17, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
VITAL CARE PHARMACY OF NORFOLK, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 17, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mitchell E Deines, RPNPI 1538640222
Title
Member/Director
Phone
(402) 223-4779

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X 605 NE Primary

Addresses

Primary practice location

120 N 27TH St
Suite 200
Norfolk, NE 68701-3286

Mailing address

120 N 27TH St
Suite 200
Norfolk, NE 68701-3286
Phone (402) 371-3444

National Provider Directory

National Provider Directory
Part of
Vital Care Norfolk Inc

Locations

120 N 27th St
Ste 200
Norfolk, NE 68701
Phone (402) 371-3444

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1426550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426550400000",
    "number": "1033502950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 N 27TH ST",
            "address_2": "SUITE 200",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687013286",
            "telephone_number": "402-371-3444",
            "fax_number": "402-371-3566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 N 27TH ST",
            "address_2": "SUITE 200",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687013286",
            "telephone_number": "402-371-3444",
            "fax_number": "402-371-3566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST NEBRASKA LTC, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VITAL CARE PHARMACY OF NORFOLK, INC",
        "enumeration_date": "2015-03-17",
        "last_updated": "2015-03-17",
        "status": "A",
        "authorized_official_last_name": "DEINES",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MEMBER/DIRECTOR",
        "authorized_official_telephone_number": "402-223-4779",
        "authorized_official_credential": "RP"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NE",
            "license": "605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.