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Susan H Polack

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

PECOS Enrollment

This provider is enrolled in PECOS as SUSAN POLACK.

Based on the most recent information from CMS, provider Susan H Polack is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1164472361
Provider Type
Individual
Full Name
Polack, Susan H
Credential
PA

Gender
Female
Sole Proprietor
No
Enumeration Date
5/11/2006
Last Updated
12/22/2015

Contact Information

Practice Location

Emile 42nd St, Omaha, NE 68198-0001

(402) 552-6731

(402) 552-6730

Mailing Location

Emile 42nd St, Omaha, NE 68198-0001

(402) 552-6731

(402) 552-6730

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 517 Nebraska

Susan H Polack

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Sink, Barbara Jean

Mcgrail, Molly Susan

Hackett, Shelby K

Peetz, Robbe Lou

Saalfeld, Kathryn Anne

Lynn, Amanda J

Vanlengen, Makenna Rose

Failla, Jessica

Brittan, Jessica M

Campbell, Sally J