Basic Information
| Provider Information | |||||||||
| NPI: | 1245880376 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ZIM ANESTHESIA LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2615 N 188TH ST | ||||||||
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| City: | ELKHORN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 680224540 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4029682455 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11606 NICHOLAS ST | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681544478 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4024932020 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/20/2019 | ||||||||
| LastUpdateDate: | 09/20/2019 | ||||||||
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| AuthorizedOfficialLastName: | NDEBELE | ||||||||
| AuthorizedOfficialFirstName: | MVIKELI | ||||||||
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| AuthorizedOfficialTitleorPosition: | CRNA | ||||||||
| AuthorizedOfficialTelephone: | 4029682455 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.