Provider Demographics
NPI:1760897797
Name:DIAGNOSTIC RADIOLOGY VEINS PC
Entity Type:Organization
Organization Name:DIAGNOSTIC RADIOLOGY VEINS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:FORBES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-493-1212
Mailing Address - Street 1:14301 FNB PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-7200
Mailing Address - Country:US
Mailing Address - Phone:402-493-1212
Mailing Address - Fax:888-972-1672
Practice Address - Street 1:345 W STEAMBOAT DR STE 401
Practice Address - Street 2:
Practice Address - City:DAKOTA DUNES
Practice Address - State:SD
Practice Address - Zip Code:57049-5287
Practice Address - Country:US
Practice Address - Phone:308-647-6444
Practice Address - Fax:866-902-2445
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DIAGNOSTIC RADIOLOGY PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-06-28
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SDS104735Medicare PIN