Healthcare Provider Details

I. General information

NPI: 1386051746
Provider Name (Legal Business Name): HEMATOLOGY & ONCOLOGY CONSULTANTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2014
Last Update Date: 07/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6901 N 72ND ST STE 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: 402-572-3524
  • Fax: 402-572-2688
Mailing address:
  • Phone: 402-572-3524
  • Fax: 402-572-2593

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number3029
License Number StateNE

VIII. Authorized Official

Name: CAROL MURTAUGH
Title or Position: PRACTICE ADMINISTRATOR
Credential: PHARMD
Phone: 402-572-3575