1598746000 NPI number — NORTHWEST RADIOLOGY CONSULTANTS, PC

Table of content: (NPI 1598746000)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598746000 NPI number — NORTHWEST RADIOLOGY CONSULTANTS, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTHWEST RADIOLOGY CONSULTANTS, 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:
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:
1598746000
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3480 PRESTON RIDGE RD STE 600
Provider Second Line Business Mailing Address:
CREDENTIALING DEPARTMENT
Provider Business Mailing Address City Name:
ALPHARETTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30005-5462
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
770-300-0101
Provider Business Mailing Address Fax Number:
770-300-0429

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2045 PEACHTREE RD NE
Provider Second Line Business Practice Location Address:
TERRACE LEVEL, SUITE 2
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30309-1414
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-352-2590
Provider Business Practice Location Address Fax Number:
404-352-3802
Provider Enumeration Date:
11/10/2005

Additional Information

Authorized Official

Authorized Official Last Name:
SCHAEFER
Authorized Official First Name:
DANIEL
Authorized Official Middle Name:
J
Authorized Official Title or Position:
COO
Authorized Official Telephone Number:
770-300-0101

Provider Taxonomy Codes

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

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





Copyright © 2007-2025 www.npivalidator.com