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General NPI Number Information
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NPI Number | 1134128085
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Entity Type | Organization
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Legal Business Name | REGIONAL PET SCAN LLC
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Dates
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Enumeration Date | 07/21/2005
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Last Update Date | 02/07/2008
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Provider Practice Location Address
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Address Line | 2000 ALBURN DR SUITE 100
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City | BEACHWOOD
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State | OH
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Zip | 44122-4314
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Country | US
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Telephone | 216-464-1917
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Fax |
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Provider Business Mailing Address
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Address Line | 3733 PARK EAST DR SUITE 100
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City | BEACHWOOD
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State | OH
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Zip | 44122-4338
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Country | US
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Telephone | 216-292-9998
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Fax | 216-292-9799
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | MRS. NANCY WESTRICH
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Credential |
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Telephone | 847-920-0500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085N0904X
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Taxonomy Name | Nuclear Radiology Physician
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License Number | 1094IC
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License Number State | OH
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