Provider Demographics
NPI:1073659215
Name:DIAGNOSTIC TECHNICAL SERVICES LLC
Entity Type:Organization
Organization Name:DIAGNOSTIC TECHNICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:HABERLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-977-5000
Mailing Address - Street 1:4520 W 69TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-8148
Mailing Address - Country:US
Mailing Address - Phone:605-977-5000
Mailing Address - Fax:605-977-5377
Practice Address - Street 1:100 MAC LN
Practice Address - Street 2:
Practice Address - City:PIERRE
Practice Address - State:SD
Practice Address - Zip Code:57501-3391
Practice Address - Country:US
Practice Address - Phone:605-977-5000
Practice Address - Fax:605-977-5377
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTH CENTRAL HEART INSTITUTE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-29
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD7290150Medicaid
SD4998159OtherSD BC BS
SD4998159OtherSD BC BS
GA470000487Medicare PIN