Provider Demographics
NPI:1174559827
Name:HEARTLAND OPEN MRI LLC
Entity type:Organization
Organization Name:HEARTLAND OPEN MRI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:BURKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-219-2999
Mailing Address - Street 1:PO BOX 1179
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67201-1179
Mailing Address - Country:US
Mailing Address - Phone:316-219-2999
Mailing Address - Fax:316-219-2990
Practice Address - Street 1:2021 N AMIDON AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-2100
Practice Address - Country:US
Practice Address - Phone:316-219-2999
Practice Address - Fax:316-219-2990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance ImagingGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS502070OtherFIRST GUARD
KS110793OtherBLUE CROSS/BLUE SHIELD
KS501008OtherHEALTH PARTNERS OF KS
KS110793Medicare ID - Type Unspecified