Provider Demographics
NPI:1023189560
Name:ADVANCED RADIOLOGY HEALTHCARE, LLC
Entity Type:Organization
Organization Name:ADVANCED RADIOLOGY HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:STUDNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-307-8553
Mailing Address - Street 1:2270 S RIDGEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-8875
Mailing Address - Country:US
Mailing Address - Phone:928-344-5006
Mailing Address - Fax:928-317-9344
Practice Address - Street 1:3885 COCHRAN ST STE J
Practice Address - Street 2:PMB 347
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-2367
Practice Address - Country:US
Practice Address - Phone:877-307-8553
Practice Address - Fax:805-583-1729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance ImagingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ087700Medicaid
AZZ109470Medicare ID - Type UnspecifiedPROVIDER ID