Basic Information
| Provider Information | |||||||||
| NPI: | 1306927983 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PRO MED SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2300 S 16TH ST | ||||||||
| Address2: | |||||||||
| City: | LINCOLN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 685023704 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4024815792 | ||||||||
| FaxNumber: | 4024814755 | ||||||||
| Practice Location | |||||||||
| Address1: | 2300 S 16TH ST | ||||||||
| Address2: | |||||||||
| City: | LINCOLN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 685023704 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4024815792 | ||||||||
| FaxNumber: | 4024814755 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/18/2006 | ||||||||
| LastUpdateDate: | 03/10/2008 | ||||||||
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| AuthorizedOfficialLastName: | AMES | ||||||||
| AuthorizedOfficialFirstName: | CRAIG | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | PESIDENT/COO | ||||||||
| AuthorizedOfficialTelephone: | 4024813548 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0127X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery |
No ID Information.