1285786665 NPI number — HOSPITAL IMAGING CO INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285786665 NPI number — HOSPITAL IMAGING CO INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOSPITAL IMAGING CO INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
KENTUCKY DIAGNOSTIC CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285786665
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/16/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2200 CONNER ROAD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HEBRON
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
41048-8142
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-344-5652
Provider Business Mailing Address Fax Number:
859-814-0025

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7200 ALEXANDRIA PIKE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALEXANDRIA
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41001-1036
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-344-5652
Provider Business Practice Location Address Fax Number:
859-814-0025
Provider Enumeration Date:
01/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
CAROLIN
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
F
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
859-814-0082

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  730058 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 65902850 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000032158 . This is a "ANTHEM" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 000000032158 . This is a "ANTHEM" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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