Provider Demographics
NPI:1053530519
Name:NEPHROLOGY CARE LLC
Entity type:Organization
Organization Name:NEPHROLOGY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRYCE
Authorized Official - Middle Name:H
Authorized Official - Last Name:LUND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-727-5863
Mailing Address - Street 1:2560 N HEALTHY WAY
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68025-2315
Mailing Address - Country:US
Mailing Address - Phone:402-727-5863
Mailing Address - Fax:402-727-7687
Practice Address - Street 1:310 E MILITARY AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-5070
Practice Address - Country:US
Practice Address - Phone:402-727-5863
Practice Address - Fax:402-727-7687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025518700Medicaid
NE099959Medicare PIN