PINE LAKE INTENSITY-MODULATED; NPI #1174674691

Contact Information

PINE LAKE INTENSITY-MODULATED

3901 PINE LAKE RD
SUITE 111
LINCOLN, NE 68516-5497

Phone: 402-481-6090
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Oncology, Radiation	261QX0203X

Indicates primary specialty

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NPI Profile & details for PINE LAKE INTENSITY-MODULATED

NPI Number	`1174674691`
LBN Legal business name	PINE LAKE INTENSITY-MODULATED
Authorized official	BENNETT BARRIOS - (MANAGING MEMBER)
Entity	Organization
Organization subpart ¹	No
Enumeration date	01/12/2007
Last updated	12/11/2009 - About 16 years ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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