1366420879 NPI number — LUMINIS HEALTH IMAGING, INC.

Table of content: (NPI 1366420879)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366420879 NPI number — LUMINIS HEALTH IMAGING, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LUMINIS HEALTH IMAGING, 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:
6
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:
1366420879
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/08/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 404433
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30384-4433
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
443-481-5330
Provider Business Mailing Address Fax Number:
443-481-5882

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2000 MEDICAL PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANNAPOLIS
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21401-3742
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
443-481-5330
Provider Business Practice Location Address Fax Number:
443-481-5882
Provider Enumeration Date:
01/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SCOTT
Authorized Official First Name:
KAREN
Authorized Official Middle Name:
M
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
443-481-5335

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: 8315136 . This is a "AETNA PPO - ALL LOCATIONS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: S645AN . This is a "CAREFIRST BCBS MARYLAND" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 146232903 . This is a "DEPT OF LABOR - KENT ISL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 60056008 . This is a "BLUE CROSS MD - BRST CTR" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: CA1932 . This is a "RR MEDICARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 1073 . This is a "BLUE CROSS DC - ALL LOC" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: G01780 . This is a "MEDICARE DC LOCAL" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 60056009 . This is a "BLUE CROSS MD - SAJAK" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 60056003 . This is a "BLUE CROSS MD - WEEMS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 146232901 . This is a "DEPT OF LABOR - NIGHTTIME" identifier . This identifiers is of the category "OTHER".
  • Identifier: 764801410 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: CK5500 . This is a "RR MEDICARE KENT ISLAND" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 60056010 . This is a "BLUE CROSS MD - KENT ISL" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: CK4885 . This is a "RR MEDICARE BOWIE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: S645AN . This is a "BLUE CROSS OF MD ALL LOC" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 0067997 . This is a "AETNA HMO - ALL OTHER" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 146232900 . This is a "DEPT OF LABOR - SAJAK &BC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 146232904 . This is a "DEPT OF LABOR - WEEMS CRK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 146232905 . This is a "DEPT OF LABOR - WAUGH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 216295 . This is a "MAMSI - ALL LOCATIONS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com