1679625040 NPI number — HOSPITAL IMAGING CO INC

Table of content: (NPI 1679625040)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679625040 NPI number — HOSPITAL IMAGING CO INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOSPITAL IMAGING CO 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:
1679625040
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/16/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2200 CONNER ROAD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HEBRON
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
41048-8142
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2200 CONNER ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HEBRON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41048-8142
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-344-5652
Provider Business Practice Location Address Fax Number:
859-814-0025
Provider Enumeration Date:
01/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
CAROLIN
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
F
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
859-814-0082

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  730070 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000000032158 . This is a "ANTHEM" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 65902850 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000032158 . This is a "ANTHEM" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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