Provider Demographics
NPI:1114164217
Name:O2 RHYTHM DIAGNOSTICS, LLC
Entity Type:Organization
Organization Name:O2 RHYTHM DIAGNOSTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:I
Authorized Official - Last Name:GOODIRCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-358-0120
Mailing Address - Street 1:7523 S STATE RD
Mailing Address - Street 2:SUITE C-1
Mailing Address - City:GOODRICH
Mailing Address - State:MI
Mailing Address - Zip Code:48438-9219
Mailing Address - Country:US
Mailing Address - Phone:810-636-3080
Mailing Address - Fax:
Practice Address - Street 1:4874 HERD RD
Practice Address - Street 2:
Practice Address - City:METAMORA
Practice Address - State:MI
Practice Address - Zip Code:48455-9760
Practice Address - Country:US
Practice Address - Phone:248-804-3023
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-11
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology