Organization Name: | HENDRY DIAGNOSTIC IMAGING CENTER |
NPI Number: | 1295862605 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | VICTOR C BASILE (DIRECTOR) |
Mailing Address: | 1008 W Sagamore Ave Clewiston |
State: | FL US |
Postal Code: | 334403420 |
Phone Number: | 8639831103 |
Fax Number: | 8639830307 |
NPI Enumeration Date: | 02/27/2007 |
NPI Last Update Date: | 02/01/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM1200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Magnetic Resonance Imaging (MRI) |
Taxonomy Definition: |