Pine Lake Health Llc
Family Medicine
2611 S 70th St, Lincoln
Nebraska, 68506-2960
402-423-4200 402-423-4201
Pine Lake Health Llc is a Family Medicine in Lincoln, Nebraska. It is located at 2611 S 70th St, Lincoln and it's customer support contact number is 402-423-4200. The authorized person of Pine Lake Health Llc is Mr. Matthew M Glenn, MD who is President of this DME and his contact number is 402-423-4200. Pine Lake Health Llc accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Pine Lake Health Llc is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
DME Supplier Details:
Pine Lake Health Llc type, location, contact phone number and fax are as below. Patients can directly walkin or can call on the below given customer support phone number for enquiries.
| Name: | Pine Lake Health Llc |
| Type: | Family Medicine |
| Location: | 2611 S 70th St, Lincoln,
Nebraska, 68506-2960 |
| Phone: | 402-423-4200 |
| Fax: | 402-423-4201 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this supplier is as below. Person's position and contact details are also mentioned below.
| Name: | Mr. Matthew M Glenn |
| Credentials: | MD |
| Position: | President |
| Contact Number: | 402-423-4200 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given supplier are as mentioned below.
| NPI Number: | 1417908666 |
| NPI Enumeration Date: | 12 May, 2006 |
| NPI Last Update On: | 30 Aug, 2022 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Pine Lake Health Llc are as mentioned below.
| Specialization | License Number | State | Status | |
| Family Medicine | | | Primary | |
| Durable Medical Equipment & Medical Supplies | | | Secondary | |
| Physician Assistant | | | Secondary | |
| Nurse Practitioner | | | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of this supplier such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 02800 | Other | Nebraska | Bcbs |
| 10025371800 | Medicaid | Nebraska | |
Medicare Enrollment:
Pine Lake Health Llc is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
| PAC ID: |
Enrollment ID: |
Org Name | Medicare Entity Type |
| 1557372919 | O20060522000133 | Pine Lake Health, Llc | PART B SUPPLIER - CLINIC/GROUP PRACTICE |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 2611 S 70th St,
Lincoln, Nebraska |
| Zip: | 68506-2960 |
| Phone Number: | 402-423-4200 |
| Fax Number: | 402-423-4201 |
Patients can reach Pine Lake Health Llc at
2611 S 70th St, Lincoln, Nebraska or can
call on customer care at 402-423-4200.
Comments/ Reviews:
Read all the reviews posted for Pine Lake Health Llc below. You may also share your own experience with Pine Lake Health Llc. Your feedback can help others make better decisions.
**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 09 February, 2026.