Healthcare Provider Details

I. General information

NPI: 1932178530
Provider Name (Legal Business Name): ONCOLOGY HEMATOLOGY WEST, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8303 DODGE ST SUITE 250
OMAHA NE
68114-4108
US

IV. Provider business mailing address

PO BOX 241578
OMAHA NE
68124-5578
US

V. Phone/Fax

Practice location:
  • Phone: 402-354-8124
  • Fax: 402-354-8127
Mailing address:
  • Phone: 402-537-5600
  • Fax: 402-339-7985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT M LANGDON JR.
Title or Position: PRESIDENT
Credential: M.D.
Phone: 402-354-8124