NEBRASKA ADVANCED RADIOLOGY LLC NPI 1558443028

NPI Information

NPI: 1558443028
Provider Name: NEBRASKA ADVANCED RADIOLOGY, LLC

Former Legal Business Name: MOLECULAR DIAGNOSTICS OF EASTERN OMAHA, LLC

Classification: Clinic/Center - 261QR0200X
Entity Type: Organization

Specialization: Radiology

Address:
117 NORTH 32ND AVENUE
SUITE 100
OMAHA, NE
ZIP 68131
Phone: (402) 715-5200
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NEBRASKA ADVANCED RADIOLOGY, LLC is a radiology clinic center in Omaha, NE. NEBRASKA ADVANCED RADIOLOGY, LLC NPI is 1558443028. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Molecular Diagnostics Of Eastern Omaha, Llc.

The provider's business location address is:

117 NORTH 32ND AVENUE
SUITE 100
OMAHA, NE
ZIP 68131-505
Phone: (402) 715-5200
Fax: (402) 715-5201

The provider's authorized official is Robin S Nelson .
The authorized official title is Manager and has the following contact phone number (402) 715-5200.

The enumeration date for this NPI number is 10/20/2006 and was last updated on 2/18/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0200X	Clinic/Center	Radiology		ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1558448028	MEDICAID	IOWA
2	10025469000	MEDICAID	NEBRASKA
3	=========	OTHER	NEBRASKA	TAX ID
4	099894	MEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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