Organization
ENVISION OPEN MRI LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL D. RAASCH (MANAGING MEMBER)
(402) 467-5335
Entity
Organization
Contact information
Practice address
300 N 44TH ST, STE 102, LINCOLN, NE 68503-3415
(402) 467-5335
Mailing address
300 N 44TH ST, STE 102, LINCOLN, NE 68503-3415
(402) 467-5335
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01899001
BCBS OF NE
NE
05
—
10025579500
—
NE
01
—
P00629620
RR MEDICARE
NE
Enumeration date
10/24/2007
Last updated
08/13/2012
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