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General NPI Number Information
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NPI Number | 1629036223
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Entity Type | Organization
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Legal Business Name | PROSCAN IMAGING OF PICKERINGTON, LLC
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 11/04/2019
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Provider Practice Location Address
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Address Line | 1797 HILL RD N STE 102
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City | PICKERINGTON
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State | OH
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Zip | 43147-7996
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Country | US
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Telephone | 614-920-6364
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Fax |
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Provider Business Mailing Address
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Address Line | 417 HILL RD N
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City | PICKERINGTON
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State | OH
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Zip | 43147-1310
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Country | US
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Telephone | 614-920-6364
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Fax | 614-920-6368
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Authorized Official
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Title or Position | COO
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Name | KAREN AMAYA
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Credential |
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Telephone | 513-924-5174
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 1206IC
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License Number State | OH
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