Provider Demographics
NPI:1508973082
Name:ADVANCED RADIATION THERAPY AND ONCOLOGY, PC
Entity Type:Organization
Organization Name:ADVANCED RADIATION THERAPY AND ONCOLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:UNDINE
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:HOWELL-BURKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-483-5799
Mailing Address - Street 1:PO BOX 6971
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-0971
Mailing Address - Country:US
Mailing Address - Phone:402-486-7027
Mailing Address - Fax:402-486-7300
Practice Address - Street 1:555 S 70TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2462
Practice Address - Country:US
Practice Address - Phone:402-483-5799
Practice Address - Fax:402-434-6047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025009000Medicaid
NEDB6526OtherMEDICARE RAILROAD
NE10025009000Medicaid