Provider Demographics
NPI:1033683750
Name:DMC DIAGNOSTICS INC
Entity Type:Organization
Organization Name:DMC DIAGNOSTICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DOLORES
Authorized Official - Middle Name:
Authorized Official - Last Name:CAGLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-421-9316
Mailing Address - Street 1:55 LAKE HAVASU AVE S STE F142
Mailing Address - Street 2:
Mailing Address - City:LAKE HAVASU CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86403-0938
Mailing Address - Country:US
Mailing Address - Phone:714-421-9316
Mailing Address - Fax:866-678-5321
Practice Address - Street 1:55 LAKE HAVASU AVE S STE F142
Practice Address - Street 2:
Practice Address - City:LAKE HAVASU CITY
Practice Address - State:AZ
Practice Address - Zip Code:86403-0938
Practice Address - Country:US
Practice Address - Phone:714-421-9316
Practice Address - Fax:866-678-5321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-15
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier