Coulee Diagnostic Radiology Inc
LBN: Coulee Diagnostic Radiology Inc
Coulee Diagnostic Radiology Inc is an health care organization with primary practice located at 1580 Heritage Blvd , West Salem WI 54669-9418. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Radiology, Ambulatory Health Care Facilities / Radiology, Mammography. Ambulatory Health Care Facilities / Radiology is the primary health care specialty.
Coulee Diagnostic Radiology Inc can be contacted via phone (608) 518-3406, or through Omoba, Emmanuel via phone (608) 518-3406.
Contact Information
Primary practice address
1580 Heritage Blvd
West Salem WI 54669-9418
Phone: (608) 518-3406
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Radiology | 261QR0200X | ||
| Ambulatory Health Care Facilities / Radiology, Mammography | 261QR0206X |
Profile Details
| NPI number | 1063036408 |
|---|---|
| LBN Legal business name | Coulee Diagnostic Radiology Inc |
| DBA Doing business as | |
| Authorized official | Omoba, Emmanuel Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 1st, 2020 |
| Last updated | Jun 15th, 2020 - about 4 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063036408 | NPPES |
| Wisconsin | MEDICAID | F37837 | |
| Wisconsin | MEDICAID | 32447500 |
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