Healthcare Provider Details

I. General information

NPI: 1043268493
Provider Name (Legal Business Name): DIAGNOSTIC HEALTH CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 02/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

902 W TEMPLE AVE
EFFINGHAM IL
62401-2178
US

IV. Provider business mailing address

2764 PELHAM PKWY
PELHAM AL
35124-1702
US

V. Phone/Fax

Practice location:
  • Phone: 217-342-2226
  • Fax: 217-342-2226
Mailing address:
  • Phone: 205-685-5141
  • Fax: 205-994-7170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHERI MILLER
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 205-685-5000