ALEGENT CREIGHTON HEALTH (NPI# 1780753632) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780753632 |
| Entity Type | Organization |
| Organization Name | ALEGENT CREIGHTON HEALTH |
| Other Organization Name | CHI HEALTH PHARMACY-LAKESIDE |
| Practice Address |
16909 Lakeside Hills Ct Ste 107 Omaha NE 68130-4664 |
| Practice Telephone | 4027585006 |
| Practice Fax Number | 4027585094 |
| Mailing Telephone | 4027585006 |
| Mailing Fax Number | 4027585094 |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2017-04-27 |
| Authorized Official Name | MATTHEW HAZEN (DIRECTOR) |
| Authorized Official Telephone | 4023434546 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
2661 | NE | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 2814879 | 01 | |
| NE | 10026519109 | 05 |
| Other Name | Type Code |
|---|---|
| CHI Health Pharmacy-Lakeside | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295293744 | Alegent Creighton Health | Durable Medical Equipment & Medical Supplies | 1288 Valley View Drive, Pharmacy Ste 101, Council Bluffs, IA 51503-5245 | 2019-03-04 |
| 1104251628 | Alegent Creighton Health | Radiology | 17201 Wright St Ste 100, Omaha, NE 68130-2042 | 2013-09-04 |
| 1952660615 | Alegent Creighton Health | Durable Medical Equipment & Medical Supplies | 8248 S 96th St Ste 101, La Vista, NE 68128-3126 | 2012-05-15 |
| 1427317205 | Alegent Creighton Health | Durable Medical Equipment & Medical Supplies | 13315 W Center Rd Ste 101, Omaha, NE 68144-3449 | 2012-05-14 |
| 1164553954 | Alegent Creighton Health | Durable Medical Equipment & Medical Supplies | 17201 Wright St, Suite 202, Omaha, NE 68130-2042 | 2007-03-07 |
| 1033288923 | Alegent Creighton Health | Dietitian, Registered | 12809 W Dodge Road, Omaha, NE 68154-2155 | 2006-11-07 |
| 1083700959 | Alegent Creighton Health | Durable Medical Equipment & Medical Supplies | 3308 Samson Way Ste 106a, Bellevue, NE 68123-3235 | 2006-10-05 |
| 1760578652 | Alegent Creighton Health | Durable Medical Equipment & Medical Supplies | 16909 Lakeside Hills Ct Ste 107, Omaha, NE 68130-4661 | 2006-10-05 |
| 1508213810 | Alegent Creighton Health | Clinic/Center | 11111 S 84th St, Papillion, NE 68046-4122 | 2016-05-17 |
| 1376910448 | Alegent Creighton Health | Durable Medical Equipment & Medical Supplies | 4220 L St, Omaha, NE 68107-1048 | 2015-08-25 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ALEGENT CREIGHTON HEALTH | 7261 Mercy Rd, Omaha, NE 68124-2311 |
| Washington State Corporations | ALEGENT CREIGHTON HEALTH | 12809 W Dodge Rd, Omaha, NE 68154 |
| Street Address |
16909 LAKESIDE HILLS CT STE 107 |
| City | OMAHA |
| State | NE |
| Zip Code | 68130-4664 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366448649 | Scott C Nelson | Podiatrist | 16909 Lakeside Hills Ct, Ste 208, Omaha, NE 68130-4664 | 2005-06-22 |
| 1114467727 | Ashley Ryan Schwartz | Physician Assistant | 16909 Lakeside Hills Ct, #208, Omaha, NE 68130-4664 | 2017-03-01 |
| 1588012397 | Alegent Creighton Clinic | Podiatrist | 16909 Lakeside Hills Ct, Suite 208, Omaha, NE 68130-4664 | 2016-06-02 |
| 1083074751 | Leah B Ridder | Nurse Practitioner | 16909 Lakeside Hills Ct, Suite 300, Omaha, NE 68130-4664 | 2016-02-24 |
| 1972907822 | Kathryn Graeve | Nurse Practitioner | 16909 Lakeside Hills Ct, Suite 400, Omaha, NE 68130-4664 | 2014-10-21 |
| 1952649162 | Samantha J. Korth | Physician Assistant | 16909 Lakeside Hills Ct, #208, Omaha, NE 68130-4664 | 2013-01-22 |
| 1801150511 | Anthony Robert Mann | Physician Assistant | 16909 Lakeside Hills Ct, Suite 208, Omaha, NE 68130-4664 | 2012-06-27 |
| 1174842298 | Margaret Wollschlager Ingemansen | Family Medicine | 16909 Lakeside Hills Ct, Suite 300, Omaha, NE 68130-4664 | 2010-05-28 |
| 1417149741 | Lakeside Orthopedics PC | Durable Medical Equipment & Medical Supplies | 16909 Lakeside Hills Ct, Suite 208, Omaha, NE 68130-4664 | 2007-08-10 |
| 1043417710 | Scott C Nelson Dpm | Podiatrist | 16909 Lakeside Hills Ct, North Professional Center #208, Omaha, NE 68130-4664 | 2007-06-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861998270 | Samantha June Curto | Nurse Practitioner | 17021 Lakeside Drive, Suite 200, Omaha, NE 68130 | 2018-04-04 |
| 1780196451 | Heritage Oncare Home Health LLC | Home Health | 16934 Frances St Ste 200, Omaha, NE 68130 | 2017-11-02 |
| 1497281745 | Dental Professionals of Nebraska, PC | Dentist | 17810 Pierce Plaza, Suite 100, Omaha, NE 68130 | 2017-05-05 |
| 1891166492 | Stephanie Tupper | Speech-Language Pathologist | 16338 Oak Circle, Omaha, NE 68130 | 2015-10-08 |
| 1194036723 | Anthony John Macdissi | Internal Medicine | 16901 Lakeside Hills Court, Attn: Hospital Medicine Dept., Omaha, NE 68130 | 2010-06-29 |
| 1568613305 | Kelly Marie Barkmeier | Occupational Therapist | 1906 South 196th Street, Omaha, NE 68130 | 2008-10-09 |
| 1306009758 | Melissa Sue Loseke | Family Medicine | 17021 Lakeside Hills Plz #200, Omaha, NE 68130 | 2008-07-07 |
| 1477724417 | Denise L. Pollard | Nurse Practitioner | 17525 Gold Plaza Ste 116, Omaha, NE 68130 | 2008-03-18 |
| 1508053943 | Omaha Family Medicine, P.C. | Family Medicine | 17841 Pierce Plz, Omaha, NE 68130 | 2007-10-01 |
| 1669672523 | Jennifer L Liu | Family Medicine | 16909 Lakeside Hills, Ste 300, Omaha, NE 68130 | 2007-07-19 |
| Find all providers in zip 68130 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801374491 | Walnut Creek LLC | Pharmacy | 11020 Q Street, Omaha, NE 68137 | 2018-08-06 |
| 1568704948 | Jsk Drug LLC | Pharmacy | 11722 Stonegate Cir, Omaha, NE 68164-3692 | 2013-03-22 |
| 1164763470 | Midwest Surgical Hosptial, LLC. | Pharmacy | 7915 Farnam Dr, Omaha, NE 68114-4504 | 2013-03-12 |
| 1427397322 | Stonybrook Pharmacy LLC | Pharmacy | 13921 S Plz, Omaha, NE 68137-2916 | 2013-02-12 |
| 1710206768 | Nf Foods LLC | Pharmacy | 1221 S 203rd St, Omaha, NE 68130-2808 | 2010-05-28 |
| 1326295478 | Rockbrook Health Mart Pharmacy | Pharmacy | 10913 Prairie Brook Rd, Omaha, NE 68144-4828 | 2008-08-20 |
| 1124211206 | Costco Wholesale Corporation | Pharmacy | 12300 W Dodge Rd, Omaha, NE 68154 | 2007-08-22 |
| 1932242609 | No Frills Pharmacy LLC | Pharmacy | 8005 Blondo St, Omaha, NE 68134-6664 | 2007-02-14 |
| 1013050780 | No Frills Pharmacy LLC | Pharmacy | 820 N Saddle Creek Rd, Omaha, NE 68132-2520 | 2007-02-14 |
| 1194866582 | Keystone Wholesale Co | Pharmacy | 7328 Maple St, Omaha, NE 68134-6829 | 2007-02-09 |
| Find all providers in OMAHA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.