55Th Medical Group

LBN: Ehrling Bergquist Clinic
55Th Medical Group is an health care organization with primary practice located at 2501 Capehart Rd Ste 105, Offutt A F B NE 68113-1043. The organization recently has 4 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Military/U.S. Coast Guard Outpatient, Ambulatory Health Care Facilities / Military and U.S. Coast Guard Ambulatory Procedure, Hospitals / Military Hospital, Suppliers / Military/U.S. Coast Guard Pharmacy. Hospitals / Military Hospital is the primary health care specialty. Ehrling Bergquist Clinic can be contacted via phone (402) 294-9215, or through Hansken, Serena Lynn via phone (703) 588-6419.

Contact Information

Primary practice address
2501 Capehart Rd Ste 105 Offutt A F B NE 68113-1043
Phone: (402) 294-9215
Fax: (402) 294-7463
Website:
Map and Directions
Authorized official contact:
Name: Hansken, Serena Lynn
Phone: (703) 588-6419

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Military/U.S. Coast Guard Outpatient 261QM1100X
Ambulatory Health Care Facilities / Military and U.S. Coast Guard Ambulatory Procedure 261QM1101X
Hospitals / Military Hospital 286500000X
Suppliers / Military/U.S. Coast Guard Pharmacy 332000000X

Profile Details

NPI number 1316919160
LBN Legal business name Ehrling Bergquist Clinic
DBA Doing business as 55Th Medical Group
Authorized official Hansken, Serena Lynn
Entity Organization
Organization subpart 1 No
Enumeration date Feb 6th, 2006
Last updated Nov 15th, 2010 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316919160 NPPES
Nebraska Other 2815706 NCPDP

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