1518299957 NPI number — F&S RADIOLOGY PC

Table of content: (NPI 1518299957)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518299957 NPI number — F&S RADIOLOGY PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
F&S RADIOLOGY PC
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:
1518299957
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/08/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5565 CENTERVIEW DR STE 107
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RALEIGH
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27606-3563
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:
866-396-8340

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3700 PARK EAST DR
Provider Second Line Business Practice Location Address:
SUITE 450
Provider Business Practice Location Address City Name:
BEACHWOOD
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44122-4305
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
855-292-1401
Provider Business Practice Location Address Fax Number:
866-396-8340
Provider Enumeration Date:
02/10/2010

Additional Information

Authorized Official

Authorized Official Last Name:
KONDAS
Authorized Official First Name:
KATHY
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICER
Authorized Official Telephone Number:
877-328-1119

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: 442184100 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1518299957 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: GP5506 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0020746 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3076853 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 003116726A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 057763900 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 681560 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100111880 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1025173750001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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