Organization
OMEGA NUCLEAR LLC
Active
Parent organization
DIA PRACTICE ENTERPRISES LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
DIA PRACTICE ENTERPRISES LLC
Authorized official
VICTORIA L PEACOCK MS, MS (PROJECT MANAGER)
(302) 993-2330
Entity
Organization
Contact information
Practice address
L12 OMEGA DRIVE, NEWARK, DE 19713-2077
(302) 368-8150
(302) 368-3412
Mailing address
1601 MILLTOWN RD, SUITE 13, WILMINGTON, DE 19808-4027
(302) 993-2330
(302) 993-2344
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000142702
—
DE
Enumeration date
05/03/2006
Last updated
12/21/2012
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