1477513224 NPI number — UNITED RADIOLOGY GROUP, CHARTERED

Table of content: DR. SALLIE REID TASTO PH.D. (NPI 1760531578)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477513224 NPI number — UNITED RADIOLOGY GROUP, CHARTERED

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNITED RADIOLOGY GROUP, CHARTERED
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:
1477513224
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/11/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2327
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SALINA
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
67402-2327
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
785-827-9526
Provider Business Mailing Address Fax Number:
785-827-2854

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
119 W IRON AVE
Provider Second Line Business Practice Location Address:
5TH FLOOR
Provider Business Practice Location Address City Name:
SALINA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67401-2600
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-827-9526
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BOSTELMAN
Authorized Official First Name:
DEBRA
Authorized Official Middle Name:
Authorized Official Title or Position:
BUSINESS OFFICE MGR
Authorized Official Telephone Number:
785-827-9526

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: 100088880A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 300037006 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".




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