Healthcare Provider Details

I. General information

NPI: 1164595906
Provider Name (Legal Business Name): HEMATOLOGY & ONCOLOGY CONSULTANTS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4508 38TH ST SUITE 120
COLUMBUS NE
68601-1668
US

IV. Provider business mailing address

PO BOX 641850
OMAHA NE
68164-7850
US

V. Phone/Fax

Practice location:
  • Phone: 402-562-2261
  • Fax: 402-562-2264
Mailing address:
  • Phone: 402-572-3529
  • Fax: 402-572-2892

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number13385
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number15291
License Number StateNE
# 3
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number21140
License Number StateNE
# 4
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number20876
License Number StateNE
# 5
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number110233
License Number StateNE
# 6
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number22157
License Number StateNE

VIII. Authorized Official

Name: MRS. CAROLYNNE RENEA PARKER
Title or Position: CLINIC COORDINATOR
Credential:
Phone: 402-572-3529