Basic Information
| Provider Information | |||||||||
| NPI: | 1336191857 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALARID | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | RUPERT | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4750 HEMPSTEAD STATION DR | ||||||||
| Address2: | |||||||||
| City: | KETTERING | ||||||||
| State: | OH | ||||||||
| PostalCode: | 454295164 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8008750136 | ||||||||
| FaxNumber: | 9376194342 | ||||||||
| Practice Location | |||||||||
| Address1: | 11111 S 84TH ST | ||||||||
| Address2: | |||||||||
| City: | PAPILLION | ||||||||
| State: | NE | ||||||||
| PostalCode: | 680464122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4025933550 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/16/2006 | ||||||||
| LastUpdateDate: | 06/13/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 16176 | NE | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 01047 | 01 | BCBS | OTHER | 100249951-00 | 05 | NE | MEDICAID | 6982710 | 05 | IA | MEDICAID | 1016 | 01 | MIDLANDS CHOICE/MUT OMAHA | OTHER | 39-00186 | 01 | NE | SHAREADVANTAGE MEDICAID | OTHER | 3982710 | 05 | IA | MEDICAID |