Provider Demographics
NPI:1710079462
Name:HASTINGS RADIOLOGY ASSOCIATES PC
Entity Type:Organization
Organization Name:HASTINGS RADIOLOGY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:HEROLD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-461-5191
Mailing Address - Street 1:PO BOX 2176
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68902-2176
Mailing Address - Country:US
Mailing Address - Phone:402-461-5191
Mailing Address - Fax:402-461-5088
Practice Address - Street 1:715 N SAINT JOSEPH AVE
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-4451
Practice Address - Country:US
Practice Address - Phone:402-461-5191
Practice Address - Fax:402-461-5088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO3665OtherRAILROAD MEDICARE
NE02830OtherBCBS
KS110691OtherBCBS KANSAS
CO3665OtherRAILROAD MEDICARE
NE=========13Medicaid
NE095031Medicare PIN