Organization Name: | PREMIUM DIAGNOSTICS CENTER LLC |
NPI Number: | 1467763169 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KARI DLUGOSZ (MANAGER) |
Mailing Address: | 5319 Hoag Dr Sheffield Village |
State: | OH US |
Postal Code: | 440351494 |
Phone Number: | 4409306020 |
Fax Number: | |
NPI Enumeration Date: | 06/28/2010 |
NPI Last Update Date: | 06/29/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Radiology |
Taxonomy Definition: |