Wagelie, Rick

Wagelie, Rick is an sole proprietor health care provider with primary practice located at 5156 S 197Th Avenue Cir , Omaha NE 68135-3679. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Wagelie, Rick can be contacted via phone (402) 290-0931.

Contact Information

Primary practice address
5156 S 197Th Avenue Cir Omaha NE 68135-3679
Fax: (402) 597-0382
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X # 421 Nebraska

Profile Details

NPI number 1942200936
LBN Legal business name Wagelie, Rick
Credentials OTR/L
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 30th, 2005
Last updated Mar 18th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942200936 NPPES
Nebraska Other 09203 BLUE CROSS BLUE SHIELD #
Nebraska MEDICAID 470807419-00 BLUE CROSS BLUE SHIELD #

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