Organization
CLEARVIEW MOBILE IMAGING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ZACHARY B EVANS (MEMBER)
(816) 232-2727
Entity
Organization
Contact information
Practice address
11912 ELM ST, SUITE 122, OMAHA, NE 68144-4387
(816) 232-2727
(816) 232-2771
Mailing address
306 S BELT HWY, SAINT JOSEPH, MO 64506-3418
(816) 232-2727
(816) 232-2771
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
—
—
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0586552
MEDICAID
IA
01
—
099607
MEDICARE
NE
01
—
100251900
MEDICAID
NE
01
—
10025190700
MEDICAID
NE
01
—
717253009
MEDICAID
MO
01
—
I14667
MEDICARE
IA
01
—
P00181866
RAILROAD MEDICARE
—
Enumeration date
04/03/2006
Last updated
11/01/2011
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