Organization Name: | REGIONAL DIAGNOSTICS, LLC |
NPI Number: | 1144218462 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RON CLARK (DIRECTOR, MANAGED CARE) |
Mailing Address: | 16236 Prince Dr South Holland |
State: | IL US |
Postal Code: | 604733233 |
Phone Number: | 7083331400 |
Fax Number: | 7083330110 |
NPI Enumeration Date: | 10/11/2005 |
NPI Last Update Date: | 04/20/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Radiology |
Taxonomy Definition: |