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NPI Code Detail

MEDICARE: HEARTLAND OPEN MRI LLC

MEDICARE: HEARTLAND OPEN MRI LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12471M1202XMagnetic Resonance Imaging Radiologic Technologist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1502070OTHERKSFIRST GUARD
2110793OTHERKSBLUE CROSS/BLUE SHIELD
3501008OTHERKSHEALTH PARTNERS OF KS

General Provider Information

NPI Number : 1174559827
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEARTLAND OPEN MRI LLC
Provider Business Mailing Address
First Line : PO BOX 1179
Second Line :
City : WICHITA
State : KS
Zip : 67201-1179
Country : US
Telephone Number : 316-219-2999
Fax Number : 316-219-2990
Provider Business Practice Location Address
First Line : 2021 N AMIDON AVE
Second Line :
City : WICHITA
State : KS
Zip : 67203-2100
Country : US
Telephone Number : 316-219-2999
Fax Number : 316-219-2990
Authorized Official
Title or Position : COO
Name : MR. ALAN L BURKE
Credential :
Telephone Number : 316-219-2999
Provider Enumeration Date : 06/24/2006
Last Update Date : 08/22/2020

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Directions to “HEARTLAND OPEN MRI LLC ” Practice Location

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