Basic Information
| Provider Information | |||||||||
| NPI: | 1881628493 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RADIOLOGY AND IMAGING SERVICES READING CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 931286 | ||||||||
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| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441931494 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8887199012 | ||||||||
| FaxNumber: | 3304937123 | ||||||||
| Practice Location | |||||||||
| Address1: | 2603 W MARKET ST | ||||||||
| Address2: | |||||||||
| City: | AKRON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 443134208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3308677274 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2006 | ||||||||
| LastUpdateDate: | 07/08/2008 | ||||||||
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| AuthorizedOfficialLastName: | LARM | ||||||||
| AuthorizedOfficialFirstName: | SHERRIE | ||||||||
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| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 3308677274 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | RADIOLOGY AND IMAGING SERVICES INC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | CN1167 | 01 | OH | RAILROAD MEDICARE | OTHER |