1164492799 NPI number — BEST DIAGNOSTIC SERVICES INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164492799 NPI number — BEST DIAGNOSTIC SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BEST DIAGNOSTIC SERVICES INC
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:
1164492799
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/16/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9403 KENWOOD RD
Provider Second Line Business Mailing Address:
C109
Provider Business Mailing Address City Name:
BLUE ASH
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45242-6895
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-793-2283
Provider Business Mailing Address Fax Number:
513-793-2368

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9403 KENWOOD RD
Provider Second Line Business Practice Location Address:
C109
Provider Business Practice Location Address City Name:
BLUE ASH
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45242-6895
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-793-2283
Provider Business Practice Location Address Fax Number:
513-793-2368
Provider Enumeration Date:
01/25/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ZALTSMAN
Authorized Official First Name:
IGOR
Authorized Official Middle Name:
GARRY
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
513-793-2283

Provider Taxonomy Codes

  • Taxonomy code: 2471S1302X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2555006 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".