Organization
MCMC RADIOLOGY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT C. HELENIAK (MANAGING MEMBER)
(208) 584-3526
Entity
Organization
Contact information
Practice address
5310 W CAPITOL DR, MILWAUKEE, WI 53216-2239
(414) 873-7000
(414) 873-8632
Mailing address
5100 MONTOUR RD, EMMETT, ID 83617-5016
(208) 584-3526
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21268900
—
WI
Enumeration date
05/10/2006
Last updated
08/22/2020
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