Provider Demographics
NPI:1891866562
Name:HEMATOLOGY & ONCOLOGY CONSULTANTS, PC
Entity Type:Organization
Organization Name:HEMATOLOGY & ONCOLOGY CONSULTANTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLYNNE
Authorized Official - Middle Name:RENEA
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-572-3529
Mailing Address - Street 1:PO BOX 641850
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68164-7850
Mailing Address - Country:US
Mailing Address - Phone:402-572-3529
Mailing Address - Fax:402-572-2892
Practice Address - Street 1:800 MERCY DR
Practice Address - Street 2:SUITE 10
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503-3128
Practice Address - Country:US
Practice Address - Phone:712-388-2810
Practice Address - Fax:712-388-2812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA32052207RH0003X
IA23365207RH0003X
IA32519207RH0003X
IA33127207RH0003X
IA23373207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0747394Medicaid
IACI2145OtherRAILROAD MEDICARE
IA16D0968649OtherCLIA NUMBER
G70529Medicare UPIN
B67934Medicare UPIN
IA06885Medicare ID - Type UnspecifiedIOWA GROUP MEDICARE
IA0747394Medicaid
G99720Medicare UPIN
B67791Medicare UPIN