Provider Demographics
NPI:1083809792
Name:IMAGING CENTER OF HASTINGS, L.L.C.
Entity Type:Organization
Organization Name:IMAGING CENTER OF HASTINGS, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-463-2431
Mailing Address - Street 1:2115 N KANSAS AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-2615
Mailing Address - Country:US
Mailing Address - Phone:402-463-2431
Mailing Address - Fax:402-463-2486
Practice Address - Street 1:2115 N KANSAS AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-2615
Practice Address - Country:US
Practice Address - Phone:402-463-2431
Practice Address - Fax:402-463-2486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology