1487889358 NPI number — LAWRENCE COUNTY MRI & DIAGNOSTIC IMAGING CENTER, LLC

Table of content: (NPI 1487889358)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487889358 NPI number — LAWRENCE COUNTY MRI & DIAGNOSTIC IMAGING CENTER, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LAWRENCE COUNTY MRI & DIAGNOSTIC IMAGING CENTER, LLC
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:
Provider Other Organization Name Type Code:
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:
1487889358
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/21/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 60
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15230-0060
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-937-5726
Provider Business Mailing Address Fax Number:
412-937-5706

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2526 WILMINGTON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW CASTLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16105-1644
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-658-1800
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/21/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PICA
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OFFICER
Authorized Official Telephone Number:
724-935-6310

Provider Taxonomy Codes

  • Taxonomy code: 2085B0100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085N0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085N0904X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2085R0204X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085U0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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