Healthcare Provider Details

I. General information

NPI: 1740886464
Provider Name (Legal Business Name): HASTINGS MEDICAL IMAGING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2020
Last Update Date: 02/25/2021
Certification Date: 02/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2207 OSBORNE DR W STE 200
HASTINGS NE
68901-9111
US

IV. Provider business mailing address

2207 OSBORNE DR W STE 200
HASTINGS NE
68901-9111
US

V. Phone/Fax

Practice location:
  • Phone: 402-462-4070
  • Fax:
Mailing address:
  • Phone: 402-462-4070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. MARK L CALLAHAN
Title or Position: MANAGER
Credential:
Phone: 402-463-4521