1467654244 NPI number — TOWER IMAGING LLC

Table of content: (NPI 1467654244)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467654244 NPI number — TOWER IMAGING LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOWER IMAGING 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:
TGH IMAGING
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:
1467654244
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/27/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2700 UNIVERSITY SQUARE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TAMPA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33612-5513
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-253-2721
Provider Business Mailing Address Fax Number:
813-253-2299

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2700 UNIVERSITY SQUARE DRIVE
Provider Second Line Business Practice Location Address:
TOWER IMAGING INC
Provider Business Practice Location Address City Name:
TAMPA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33612-5513
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-253-2721
Provider Business Practice Location Address Fax Number:
813-253-2299
Provider Enumeration Date:
06/04/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MARTIN
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR - REVENUE CYCLE MANAGEMENT
Authorized Official Telephone Number:
813-261-2400

Provider Taxonomy Codes

  • Taxonomy code: 207U00000X ; 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: 2085P0229X ; 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" .

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

  • Identifier: 043166400 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 043166428 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".