Provider Demographics
NPI: | 1013224823 |
---|---|
Name: | SCC IMAGING, LLC |
Entity Type: | Organization |
Organization Name: | SCC IMAGING, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | ADMINISTRATOR |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | CINTHIA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | ARRIOLA |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 915-313-7325 |
Mailing Address - Street 1: | 3080 JOE BATTLE BLVD STE B |
Mailing Address - Street 2: | |
Mailing Address - City: | EL PASO |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 79938-2621 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 915-313-7325 |
Mailing Address - Fax: | 915-313-7326 |
Practice Address - Street 1: | 3080 JOE BATTLE BLVD STE B |
Practice Address - Street 2: | |
Practice Address - City: | EL PASO |
Practice Address - State: | TX |
Practice Address - Zip Code: | 79938-2621 |
Practice Address - Country: | US |
Practice Address - Phone: | 915-313-7325 |
Practice Address - Fax: | 915-313-7326 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2010-09-01 |
Last Update Date: | 2015-07-07 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QR0200X | Ambulatory Health Care Facilities | Clinic/Center | Radiology |
No | 261QR0208X | Ambulatory Health Care Facilities | Clinic/Center | Radiology, Mobile |