Healthcare Provider Details

I. General information

NPI: 1215969407
Provider Name (Legal Business Name): RADIOLOGY CONSULTANTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11902 W CENTER RD STE 200
OMAHA NE
68144-4326
US

IV. Provider business mailing address

PO BOX 4460
OMAHA NE
68104
US

V. Phone/Fax

Practice location:
  • Phone: 402-398-6198
  • Fax:
Mailing address:
  • Phone: 866-491-5807
  • Fax: 913-491-0411

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: SHIRLEANE LANGE
Title or Position: ADMINISTRATOR
Credential:
Phone: 402-597-8775