Basic Information
Provider Information
NPI: 1952330649
EntityType: 2
ReplacementNPI:  
OrganizationName: ONEWORLD COMMUNITY HEALTH CENTERS, INC.
LastName:  
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Mailing Information
Address1: 4920 S 30TH ST
Address2: SUITE #103
City: OMAHA
State: NE
PostalCode: 681071590
CountryCode: US
TelephoneNumber: 4025028842
FaxNumber: 4029915642
Practice Location
Address1: 4920 S 30TH ST
Address2: SUITE #103
City: OMAHA
State: NE
PostalCode: 681071590
CountryCode: US
TelephoneNumber: 4025028842
FaxNumber: 4029915642
Other Information
ProviderEnumerationDate: 07/03/2006
LastUpdateDate: 03/10/2014
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: SKOLKIN
AuthorizedOfficialFirstName: ANDREA
AuthorizedOfficialMiddleName: MAUREEN
AuthorizedOfficialTitleorPosition: CEO
AuthorizedOfficialTelephone: 4025028842
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MRS.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: MPA
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QF0400XHC018NEY Ambulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)

No ID Information.


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