Provider Demographics
NPI:1023778248
Name:TABITHA HOME HEALTH CARE & HOSPICE LLC-A COLLABORATION WITH IMMANUEL
Entity type:Organization
Organization Name:TABITHA HOME HEALTH CARE & HOSPICE LLC-A COLLABORATION WITH IMMANUEL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:THADDEUS
Authorized Official - Middle Name:
Authorized Official - Last Name:EDGERTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-846-8538
Mailing Address - Street 1:4720 RANDOLPH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-3741
Mailing Address - Country:US
Mailing Address - Phone:402-483-7671
Mailing Address - Fax:402-486-8539
Practice Address - Street 1:1044 N 115TH ST STE 500
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-4410
Practice Address - Country:US
Practice Address - Phone:402-819-4949
Practice Address - Fax:531-375-5076
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TABITHA HOME HEALTH CARE & HOSPICE LLC-A COLLABORATION WITH IMMANUEL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-12-29
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health