1346299864 NPI number — DIAGNOSTIC HEALTH CORPORATION

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 1346299864 NPI number — DIAGNOSTIC HEALTH CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DIAGNOSTIC HEALTH CORPORATION
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:
DIAGNOSTIC HEALTH WILKES BARRE
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:
1346299864
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/15/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2764 PELHAM PKWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PELHAM
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35124-1702
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-685-5116
Provider Business Mailing Address Fax Number:
205-262-8820

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
744 KIDDER ST
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
WILKES BARRE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18702-7015
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-824-1100
Provider Business Practice Location Address Fax Number:
570-824-1112
Provider Enumeration Date:
05/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MILLER
Authorized Official First Name:
SHERI
Authorized Official Middle Name:
K
Authorized Official Title or Position:
CREDENTIALING MANAGER
Authorized Official Telephone Number:
205-685-5000

Provider Taxonomy Codes

  • Taxonomy code: 293D00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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