Provider Demographics
NPI:1164677126
Name:PLAINS RADIOLOGY SERVICES PC
Entity Type:Organization
Organization Name:PLAINS RADIOLOGY SERVICES PC
Other - Org Name:UNIVERSAL IMAGING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:HADFORD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:308-398-6400
Mailing Address - Street 1:PO BOX 2467
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68848-2467
Mailing Address - Country:US
Mailing Address - Phone:308-865-2231
Mailing Address - Fax:308-338-1671
Practice Address - Street 1:3610 RICHMOND CIR STE 100
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-3910
Practice Address - Country:US
Practice Address - Phone:308-398-6400
Practice Address - Fax:308-398-6408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-18
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103G704550Medicare PIN
CAFI711AMedicare PIN
AZZ136207Medicare PIN
NENA1200Medicare PIN
FLEY540AMedicare PIN
IAIB1823Medicare PIN
ILF100100575Medicare PIN
TX0A3373Medicare PIN
KSKA2894Medicare PIN