Provider Demographics
NPI:1932137593
Name:HEARTLAND IMAGING SPECIALISTS LLC
Entity Type:Organization
Organization Name:HEARTLAND IMAGING SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
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 1:2808 OLD FAIR RD
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-5220
Mailing Address - Country:US
Mailing Address - Phone:308-382-6856
Mailing Address - Fax:308-381-1560
Practice Address - Street 1:3610 RICHMOND CIR
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-3927
Practice Address - Country:US
Practice Address - Phone:308-398-6400
Practice Address - Fax:308-381-1560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-30
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE02813OtherBLUE CROSS BLUE SHIELD
IA0721225Medicaid
NE099843Medicare PIN
IA0721225Medicaid