COULEE DIAGNOSTIC RADIOLOGY INC (NPI# 1063036408) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063036408 |
| Entity Type | Organization |
| Organization Name | COULEE DIAGNOSTIC RADIOLOGY INC |
| Practice Address |
1580 Heritage Blvd West Salem WI 54669-9418 |
| Mailing Address |
807 Barson Ct Onalaska WI 54650-3603 |
| Practice Telephone | 6085183406 |
| Mailing Telephone | 6085183406 |
| Enumeration Date | 2020-06-01 |
| Last Update Date | 2020-06-15 |
| Authorized Official Name | EMMANUEL OMOBA (MANAGING DIRECTOR) |
| Authorized Official Telephone | 6085183406 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR0206X |
Clinic/Center Specialization: Radiology, Mammography |
Ambulatory Health Care Facilities | ||
| Y | 261QR0200X |
Clinic/Center Specialization: Radiology |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 32447500 | 05 | |
| WI | F37837 | 05 |
| Street Address |
1580 HERITAGE BLVD |
| City | WEST SALEM |
| State | WI |
| Zip Code | 54669-9418 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457918781 | Smart Choice Mri LLC | Clinic/Center | 1580 Heritage Blvd, West Salem, WI 54669-9418 | 2019-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023643699 | County of La Crosse | Custodial Care Facility | 994 Garland St E, West Salem, WI 54669 | 2020-03-04 |
| 1235763053 | County of La Crosse | Custodial Care Facility | 848 Garland St E, West Salem, WI 54669 | 2020-03-02 |
| 1750915575 | County of La Crosse | Custodial Care Facility | 856 Garland St E, West Salem, WI 54669 | 2020-03-02 |
| 1265066096 | County of La Crosse | Custodial Care Facility | 998 Garland St E, West Salem, WI 54669 | 2020-03-02 |
| 1912470113 | Erin Gleason | Music Therapist | 806 N. Mill St., West Salem, WI 54669 | 2019-01-10 |
| 1124464854 | Andrea Jayne Hatleli | Contractor | 860 N. Mill St., Suite #2, West Salem, WI 54669 | 2013-05-21 |
| 1033424403 | Sara Smith | Dentist | 201 N Leonard St, Suite 101, West Salem, WI 54669 | 2010-08-10 |
| 1073839114 | Community Health Pharmacy LLC | Pharmacy | 880 N. Mill St., Suite 101, West Salem, WI 54669 | 2010-04-14 |
| 1255350542 | Kevin P Groth | Chiropractor | 1540 Heritage Blvd, Suite 203, West Salem, WI 54669 | 2006-07-18 |
| 1063024834 | Erin Shea Vanhandel | Speech-Language Pathologist | 713 Leonard St N, West Salem, WI 54669 | 2020-08-21 |
| Find all providers in zip 54669 | ||||
| Taxonomy Code | 261QR0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649607623 | Touhy Diagnostic At Home LLC | Clinic/Center | 723 58th St, 304, Kenosha, WI 53140-4160 | 2013-10-04 |
| 1649435876 | Luck Medical Clinic | Clinic/Center | 137 1st Ave, Luck, WI 54853 | 2008-07-28 |
| 1215112966 | Mh Imaging-kenosha LLC | Clinic/Center | 1020 35th Street, Suite 120, Kenosha, WI 53140-1932 | 2007-12-31 |
| 1144392275 | St Mary's Dean Ventures Inc | Clinic/Center | 1313 Fish Hatchery Road, Madison, WI 53715 | 2006-11-14 |
| 1033121629 | Pediatric Diagnostic Imaging, S.c. | Clinic/Center | 8522 W Capitol Dr, Milwaukee, WI 53222-1827 | 2006-08-12 |
| 1528013992 | Open Mri of Delafield, LLC | Clinic/Center | 3960 Hillside Dr, Suite 106, Delafield, WI 53018-2148 | 2006-05-24 |
| 1184675506 | Cardiac Evaluation Services Inc | Clinic/Center | 2063 South 116th Street, Milwaukee, WI 53227 | 2006-05-12 |
| 1295784726 | Mcmc Radiology Services, LLC | Clinic/Center | 5310 W Capitol Dr, Milwaukee, WI 53216-2239 | 2006-05-10 |
| 1770540130 | Kenosha Radiology Center LLC. | Clinic/Center | 10117 74th St, Suite 150, Kenosha, WI 53142-7533 | 2006-04-28 |
| 1073592473 | Advanced Imaging S.c. | Clinic/Center | 228 S 18th Ave, Sturgeon Bay, WI 54235-1000 | 2006-01-13 |
| Find all providers with the same taxonomy | ||||
| City | WEST SALEM |
| Zip Code | 54669 |
Please comment or provide details below to improve the information on COULEE DIAGNOSTIC RADIOLOGY INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.