DOMERLIN SODUSTA (NPI# 1679978084) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679978084 |
| Entity Type | Individual |
| Full Name | DOMERLIN SODUSTA |
| Practice Address |
4905 S 107th Ave Suite 206 Omaha NE 68127-1965 |
| Practice Telephone | 4029681643 |
| Mailing Telephone | 4029681643 |
| Enumeration Date | 2014-10-28 |
| Last Update Date | 2014-10-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | NE | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NE | 10024973200 | 05 |
| Street Address |
4905 S 107TH AVE SUITE 206 |
| City | OMAHA |
| State | NE |
| Zip Code | 68127-1965 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720212939 | Rosemarie Nolan Tomka | Speech-Language Pathologist | 4905 S 107th Ave, Omaha, NE 68127-1965 | 2009-05-04 |
| 1538563853 | Rochelle Grady | Registered Nurse | 4905 S 107th Ave, Ste 205, Omaha, NE 68127-1965 | 2014-10-15 |
| 1386048601 | Deborah Schutz | Registered Nurse | 4905 S 107th Ave, Ste 205, Omaha, NE 68127-1965 | 2014-10-15 |
| 1356744098 | Amber Cecil | Registered Nurse | 4905 S 107th Ave, Omaha, NE 68127-1965 | 2014-10-08 |
| 1477808889 | Serenecare Inc | Hospice Care, Community Based | 4905 S 107th Ave, Suite 205, Omaha, NE 68127-1965 | 2012-07-23 |
| 1326272527 | Janice Lynn Koory | Occupational Therapist | 4905 S 107th Ave, Omaha, NE 68127-1965 | 2009-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891263604 | Lisa Ann Reyes | Massage Therapist | 7561 Main Street #402, Ralston, NE 68127 | 2018-11-09 |
| 1942709910 | Cardiac Cin of Omaha LLC | Internal Medicine | 4611 S 96th St Ste 254, Omaha, NE 68127 | 2018-02-06 |
| 1821510207 | Matthew Alan Olson | Pharmacist | 4828 South 91st Avenue Circle, Omaha, NE 68127 | 2017-07-07 |
| 1235663493 | Latifat Adekunle | Registered Nurse | 10011 J Street, Omaha, NE 68127 | 2017-04-14 |
| 1801341987 | Janelle Hill | Nurse Practitioner | 4610 S. 133rd Street Suite 109, Omaha, NE 68127 | 2016-08-18 |
| 1457713778 | Stephen Edward Wallace | Family Medicine | 6525 So. 100th Street, Omaha, NE 68127 | 2016-03-25 |
| 1669872537 | Christopher Charles Ihle | Counselor | 6550 S 84th St Ste 300, Omaha, NE 68127 | 2014-08-28 |
| 1831539048 | Airflow LLC | Durable Medical Equipment & Medical Supplies | 6221 S 90th St, Omaha, NE 68127 | 2013-07-02 |
| 1801130323 | Lilian Curtis | Social Worker | 4611 S 96th St Ste 225, Omaha, NE 68127 | 2012-11-21 |
| 1841546926 | Fidelity Home Health Care LLC | Home Health | 6650 S 84th Ave Ste 100a, Omaha, NE 68127 | 2012-07-26 |
| Find all providers in zip 68127 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356968465 | Madison County Medical Equipment, Inc | Durable Medical Equipment & Medical Supplies | 5420 F St, Omaha, NE 68117-2815 | 2020-07-06 |
| 1972120004 | Physicians Clinic Inc | Durable Medical Equipment & Medical Supplies | 6700 Mercy Rd Ste 109, Omaha, NE 68106-2613 | 2020-07-06 |
| 1487129425 | Sakrx, LLC | Durable Medical Equipment & Medical Supplies | 2915 Leavenworth St, Omaha, NE 68105-2739 | 2018-10-05 |
| 1982187654 | Us Pharmacy | Durable Medical Equipment & Medical Supplies | 7914 W Dodge Rd Ste 144, Omaha, NE 68114-3417 | 2018-09-10 |
| 1992224687 | Douglas Medical Supplies | Durable Medical Equipment & Medical Supplies | 7914 W Dodge Rd Ste 916, Omaha, NE 68114 | 2017-09-13 |
| 1265964886 | Personal Hme LLC | Durable Medical Equipment & Medical Supplies | 5346 S 136th St, 390081, Omaha, NE 68137-3001 | 2017-04-02 |
| 1306209127 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 4001 Leavenworth St Ste 150a, Omaha, NE 68105-1026 | 2016-03-30 |
| 1194108688 | Neighborhood Ltc Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 5115 S 111th St, Omaha, NE 68137-2341 | 2015-07-02 |
| 1982097804 | Miller Orthopaedic Affiliates PC | Durable Medical Equipment & Medical Supplies | 16221 Evans Plz, Omaha, NE 68116-6444 | 2015-03-17 |
| 1295132157 | Hanger Prosthetics & Orthotics East Inc | Durable Medical Equipment & Medical Supplies | 17500 Burke St Ste 100, Omaha, NE 68118-2244 | 2014-11-20 |
| 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.