1801744842 NPI number — SPECTRUM DIAGNOSTIC IMAGING SERVICES LLC

Table of content: (NPI 1801744842)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801744842 NPI number — SPECTRUM DIAGNOSTIC IMAGING SERVICES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SPECTRUM DIAGNOSTIC IMAGING SERVICES LLC
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:
1801744842
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/17/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 24
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NICKTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15762-0024
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-201-1577
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
498 AMADEI RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EBENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15931-6602
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-201-1577
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/17/2026

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
VEHOVIC
Authorized Official First Name:
LISA
Authorized Official Middle Name:
MARIE
Authorized Official Title or Position:
FOUNDER/CEO/EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
814-201-1577

Provider Taxonomy Codes

  • Taxonomy code: 246XC2903X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2471S1302X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QR0208X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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