Provider Demographics
NPI:1366513517
Name:HEMATOLOGY & ONCOLOGY CONSULTANTS, PC
Entity type:Organization
Organization Name:HEMATOLOGY & ONCOLOGY CONSULTANTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLYNNE
Authorized Official - Middle Name:RENEA
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-572-3529
Mailing Address - Street 1:PO BOX 641850
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68164-7850
Mailing Address - Country:US
Mailing Address - Phone:402-572-3529
Mailing Address - Fax:402-572-2892
Practice Address - Street 1:6901 N 72ND ST
Practice Address - Street 2:SUITE 2244
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68122-1709
Practice Address - Country:US
Practice Address - Phone:402-572-3529
Practice Address - Fax:402-572-2892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-10
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE15291207RH0003X
NE13385207RH0003X
NE20876207RH0003X
NE21140207RH0003X
NE22157207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NECI2142OtherRAILROAD MEDICARE
IA4417100002OtherDMERC
NE4417100002OtherDMERC NUMBER
IA4417100002OtherDMERC
G74737Medicare UPIN
NECI2142OtherRAILROAD MEDICARE
NE4417100002OtherDMERC NUMBER
B67791Medicare UPIN
NE=========13Medicaid
G99720Medicare UPIN