55 MDOS – NPI #1881095669
Clinic/Center

55 MDOS is an AHC clinic located in OFFUTT AFB, NE. NPPES has assigned the NPI number 1881095669 to 55 MDOS on September 11, 2014. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QP2300X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Primary Care

The NPI profile was previously updated about 11 years ago on Feb 03, 2015. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for 55 MDOS below.

NPI Profile for
55 MDOS

NPI Number
1881095669
Enumeration Date

(about 12 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
55 MDOS
Primary location
2501 CAPEHART RD
OFFUTT AFB, NE 68113-1043
Phone: (402) 232-8046 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
RAMA BHYRAVABHOTLA
DIRECTOR IPAP PHASE 2 PROGRAM
Phone: (402) 232-8046
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QP2300X
- Clinic/Center / Primary Care (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.