Provider Demographics
NPI:1215969407
Name:RADIOLOGY CONSULTANTS PC
Entity type:Organization
Organization Name:RADIOLOGY CONSULTANTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHIRLEANE
Authorized Official - Middle Name:
Authorized Official - Last Name:LANGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-597-8775
Mailing Address - Street 1:PO BOX 4460
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68104
Mailing Address - Country:US
Mailing Address - Phone:866-491-5807
Mailing Address - Fax:913-491-0411
Practice Address - Street 1:11902 W CENTER RD STE 200
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-4326
Practice Address - Country:US
Practice Address - Phone:402-398-6198
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV0943290Medicaid
NE10025039100Medicaid
NECS9045OtherRR MEDICARE
NE01939OtherBCBS
NE0575241Medicaid
NE10025038700Medicaid
IA0211557Medicaid
17829OtherIOWA BCBS
NE0943290Medicaid
IACG9162OtherRR MEDICARE
NE=========00Medicaid
IACG9162OtherRR MEDICARE
NECS9045OtherRR MEDICARE
NE0575241Medicaid
IA17829Medicare ID - Type Unspecified
NE=========00Medicaid
NV0943290Medicaid
NE092263Medicare ID - Type Unspecified