Healthcare Provider Details

I. General information

NPI: 1902855976
Provider Name (Legal Business Name): DIAGNOSTIC HEALTH CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 CROWN COLONY DR
QUINCY MA
02169-0902
US

IV. Provider business mailing address

2300 CROWN COLONY DR
QUINCY MA
02169-0902
US

V. Phone/Fax

Practice location:
  • Phone: 617-472-1575
  • Fax: 617-472-8674
Mailing address:
  • Phone: 617-472-1575
  • Fax: 617-472-8674

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 K MILLER
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 205-685-5116