Healthcare Provider Details
I. General information
NPI: 1497125850
Provider Name (Legal Business Name): ADVANCED DIAGNOSTIC IMAGING PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/29/2015
Last Update Date: 09/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1608 WILLIAMS DR SUITE 300
MURFREESBORO TN
37129-3194
US
IV. Provider business mailing address
3024 BUSINESS PARK CIR
GOODLETTSVILLE TN
37072-3132
US
V. Phone/Fax
- Phone: 615-459-3244
- Fax: 615-459-6525
- Phone: 615-851-6033
- Fax: 615-851-2018
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
CHAD
L.
CALENDINE
Title or Position: CEO
Credential: M.D.
Phone: 615-356-3999