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Contact Information

ALEGENT CREIGHTON HEALTH
3308 SAMSON WAY STE 106A
BELLEVUE, NE68123-3235
 Phone: 402-291-5076
 Fax: 402-293-9464
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
Indicates primary specialty

NPI Profile & details for ALEGENT CREIGHTON HEALTH

NPI # 1083700959
LBN Legal business name ALEGENT CREIGHTON HEALTH
Authorized official MIKE TIESI - (SENIOR DIRECTOR OF PHARMACY)
Entity Organization
Organization subpart 1 No
Enumeration date 10/05/2006
Last updated 10/23/2017 - About 9 years ago
Identifiers
NE License # 2807
IA Medicaid 0204528
NE Medicaid 10026519106
IA Other 4704 LICENSE
NE Other 2807 NEBRASKA COMMUNITY PHARMACY PERMIT
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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