1891866562 NPI number — HEMATOLOGY & ONCOLOGY CONSULTANTS, PC

Table of content: (NPI 1891866562)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891866562 NPI number — HEMATOLOGY & ONCOLOGY CONSULTANTS, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEMATOLOGY & ONCOLOGY CONSULTANTS, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1891866562
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/04/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 641850
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OMAHA
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68164-7850
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-572-3529
Provider Business Mailing Address Fax Number:
402-572-2892

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 MERCY DR
Provider Second Line Business Practice Location Address:
SUITE 10
Provider Business Practice Location Address City Name:
COUNCIL BLUFFS
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
51503-3128
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
712-388-2810
Provider Business Practice Location Address Fax Number:
712-388-2812
Provider Enumeration Date:
11/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PARKER
Authorized Official First Name:
CAROLYNNE
Authorized Official Middle Name:
RENEA
Authorized Official Title or Position:
CLINIC COORDINATOR
Authorized Official Telephone Number:
402-572-3529

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X , with the licence number:  23365 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RH0003X , with the licence number: 32519 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RH0003X , with the licence number: 33127 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RH0003X , with the licence number: 23373 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RH0003X , with the licence number: 32052 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0747394 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: CI2145 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 16D0968649 . This is a "CLIA NUMBER" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com