Provider Demographics
NPI:1992750459
Name:QUINT CITIES RADIATION ONCOLOGY, LTD
Entity type:Organization
Organization Name:QUINT CITIES RADIATION ONCOLOGY, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:L
Authorized Official - Last Name:STUART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-826-3763
Mailing Address - Street 1:PO BOX 115
Mailing Address - Street 2:
Mailing Address - City:HIAWATHA
Mailing Address - State:IA
Mailing Address - Zip Code:52233-0115
Mailing Address - Country:US
Mailing Address - Phone:319-826-3763
Mailing Address - Fax:888-609-6019
Practice Address - Street 1:TRINITY MEDICAL CENTER
Practice Address - Street 2:500 JOHN DEERE RD
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265
Practice Address - Country:US
Practice Address - Phone:309-779-5090
Practice Address - Fax:309-779-5072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILL93739Medicare PIN
IAI7421Medicare PIN