Provider Demographics
NPI:1043483910
Name:HARMONY IMAGING CENTER LLC
Entity Type:Organization
Organization Name:HARMONY IMAGING CENTER LLC
Other - Org Name:THE IMAGING CENTER - JOHNSTOWN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUNTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-619-6136
Mailing Address - Street 1:4508 ENDEAVOR DR STE 200
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:CO
Mailing Address - Zip Code:80534-4002
Mailing Address - Country:US
Mailing Address - Phone:970-282-2912
Mailing Address - Fax:
Practice Address - Street 1:4508 ENDEAVOR DR STE 200
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:CO
Practice Address - Zip Code:80534-4002
Practice Address - Country:US
Practice Address - Phone:970-282-2912
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-10
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO98576755Medicaid
COCOB5246Medicare PIN