1124068499 NPI number — RADIOLOGIC CONSULTANTS LTD

Table of content: (NPI 1124068499)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124068499 NPI number — RADIOLOGIC CONSULTANTS LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RADIOLOGIC CONSULTANTS LTD
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:
1124068499
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/14/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7 ACEE DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NATRONA HEIGHTS
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15065
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-223-5544
Provider Business Mailing Address Fax Number:
724-294-3206

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
835 HOSPITAL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
INDIANA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15701-3629
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-357-7125
Provider Business Practice Location Address Fax Number:
724-357-7482
Provider Enumeration Date:
06/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
NEWCOMER
Authorized Official First Name:
DON
Authorized Official Middle Name:
B
Authorized Official Title or Position:
PRACTICE ADMIN
Authorized Official Telephone Number:
724-226-4510

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0156752 . This is a "UMWA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 023164 . This is a "GROUP BS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1500608 . This is a "GATEWAY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0007167980009 . This is a "MEDICAL ASSISTANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: CN0798 . This is a "RR MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0007167980009 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 45059 . This is a "HEALTH AMERICA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 263623 . This is a "BLACK LUNG" identifier . This identifiers is of the category "OTHER".




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