Healthcare Provider Details
I. General information
NPI: 1245289024
Provider Name (Legal Business Name): DIAGNOSTIC HEALTH CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/09/2006
Last Update Date: 10/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1150 HAMMOND DR NE SUITE D4100
ATLANTA GA
30328-5334
US
IV. Provider business mailing address
2764 PELHAM PKWY
PELHAM AL
35124-1702
US
V. Phone/Fax
- Phone: 678-320-9030
- Fax: 678-441-0744
- Phone: 205-685-5000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 293D00000X |
| Taxonomy | Physiological Laboratory |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
SHERI
MILLER
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 205-685-5000