Provider Demographics
NPI:1679092373
Name:OMAHA TRIBE OF NEBRASKA
Entity type:Organization
Organization Name:OMAHA TRIBE OF NEBRASKA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ROWLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-837-5381
Mailing Address - Street 1:P.O. BOX 250
Mailing Address - Street 2:
Mailing Address - City:MACY
Mailing Address - State:NE
Mailing Address - Zip Code:68039-0250
Mailing Address - Country:US
Mailing Address - Phone:402-837-5381
Mailing Address - Fax:402-837-5303
Practice Address - Street 1:528 SKUNKHOLLOW DR
Practice Address - Street 2:
Practice Address - City:MACY
Practice Address - State:NE
Practice Address - Zip Code:68039-4020
Practice Address - Country:US
Practice Address - Phone:402-837-5381
Practice Address - Fax:402-837-5303
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OMAHA TRIBE OF NEBRASKA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-09-13
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========-04Medicaid