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General NPI Number Information
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NPI Number | 1609102565
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Entity Type | Organization
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Legal Business Name | ASHLAND CARDIAC IMAGING, LLC
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Dates
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Enumeration Date | 10/28/2009
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Last Update Date | 10/28/2009
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Provider Practice Location Address
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Address Line | 700 N EUGENE ST
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City | GREENSBORO
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State | NC
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Zip | 27401-1622
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Country | US
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Telephone | 336-274-2844
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Fax |
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Provider Business Mailing Address
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Address Line | 1205 MONTGOMERY AVE
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City | ASHLAND
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State | KY
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Zip | 41101-2669
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Country | US
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Telephone | 336-274-2844
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | REGINALD RICHARD SIPE
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Credential |
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Telephone | 336-274-2844
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471C3401X
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Taxonomy Name | Computed Tomography Radiologic Technologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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