Nickes Medical Supply, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

NICKES MEDICAL SUPPLY, LLC

Practice address

106 Meyer Ave BLDG 166
Offutt Afb, NE 68113-2000

Phone

(402) 291-3212

NPI assigned

Feb 12, 2019

Organization subpart

No

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

Authorized official

Name

Ngozi Kathleen Austin-Eleje

Title

Manager

Phone

(915) 533-8870

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1549929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549929600000",
    "number": "1619433828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 N STANTON ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799022509",
            "telephone_number": "915-533-8870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 MEYER AVE BLDG 166",
            "city": "OFFUTT AFB",
            "state": "NE",
            "postal_code": "681132000",
            "telephone_number": "402-291-3212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICKES MEDICAL SUPPLY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-12",
        "last_updated": "2019-02-12",
        "status": "A",
        "authorized_official_last_name": "AUSTIN-ELEJE",
        "authorized_official_first_name": "NGOZI",
        "authorized_official_middle_name": "KATHLEEN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "915-533-8870"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamarah G Murphy, M.A.
• Andrew Jason Myrtue, M.D.
• Christian Rook Albert Nelson
• Daniel Drew Nelson, DMD
• Phuc H Nguyen, DDS
• Charles Mitchell Nolder, D.O.
• Christopher Scott Nuttall, DDS
• Samia Ochia, M.D.
• Julie Rae Ostrand, WHNP
• Alycia M Owens, PA-C

• Durable Medical Equipment & Medical Supplies in Offutt Afb, NE
• Providers in Offutt Afb, NE by specialty
• Durable Medical Equipment & Medical Supplies in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2019; 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.