Healthcare Provider Details

I. General information

NPI: 1366513517
Provider Name (Legal Business Name): HEMATOLOGY & ONCOLOGY CONSULTANTS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6901 N 72ND ST SUITE 2244
OMAHA NE
68122-1709
US

IV. Provider business mailing address

PO BOX 641850
OMAHA NE
68164-7850
US

V. Phone/Fax

Practice location:
  • Phone: 402-572-3529
  • Fax: 402-572-2892
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 Number15291
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number13385
License Number StateNE
# 3
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number20876
License Number StateNE
# 4
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number21140
License Number StateNE
# 5
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