1821094186 NPI number — ASSOCIATES IN MEDICAL IMAGING, LLC

Table of content: (NPI 1821094186)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821094186 NPI number — ASSOCIATES IN MEDICAL IMAGING, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASSOCIATES IN MEDICAL 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:
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:
1821094186
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/18/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4197 FULTON DR NW
Provider Second Line Business Mailing Address:
STE C
Provider Business Mailing Address City Name:
CANTON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44718-2819
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-491-1490
Provider Business Mailing Address Fax Number:
330-491-1466

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
654 YOUNGSTOWN WARREN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NILES
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44446-4356
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-544-3636
Provider Business Practice Location Address Fax Number:
330-544-9449
Provider Enumeration Date:
06/22/2005

Additional Information

Authorized Official

Authorized Official Last Name:
SMITH
Authorized Official First Name:
SHAWN
Authorized Official Middle Name:
JOSEPH
Authorized Official Title or Position:
MEMBER
Authorized Official Telephone Number:
330-491-1490

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  1125IC , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com