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General NPI Number Information
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NPI Number | 1700597481
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Entity Type | Organization
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Legal Business Name | SPIRIT IMAGING CENTER LLC
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Dates
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Enumeration Date | 12/13/2022
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Last Update Date | 04/05/2024
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Provider Practice Location Address
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Address Line | 501 SILVERSIDE RD STE 135
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City | WILMINGTON
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State | DE
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Zip | 19809-1377
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Country | US
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Telephone | 302-448-8698
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Fax | 302-397-2828
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Provider Business Mailing Address
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Address Line | 501 SILVERSIDE RD STE 135
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City | WILMINGTON
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State | DE
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Zip | 19809-1377
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Country | US
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Telephone | 302-448-8698
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Fax | 302-269-3995
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | RICHARD TYAS
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Credential |
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Telephone | 302-448-8698
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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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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