Provider Demographics
NPI:1154439800
Name:WATKINS-TSAI IMAGING CENTER LLC
Entity Type:Organization
Organization Name:WATKINS-TSAI IMAGING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:RUEY JY
Authorized Official - Middle Name:
Authorized Official - Last Name:TSAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-532-6131
Mailing Address - Street 1:205 MARION PIKE
Mailing Address - Street 2:
Mailing Address - City:COAL GROVE
Mailing Address - State:OH
Mailing Address - Zip Code:45638
Mailing Address - Country:US
Mailing Address - Phone:740-532-6131
Mailing Address - Fax:740-532-6082
Practice Address - Street 1:205 MARION PIKE
Practice Address - Street 2:
Practice Address - City:COAL GROVE
Practice Address - State:OH
Practice Address - Zip Code:45638
Practice Address - Country:US
Practice Address - Phone:740-532-6131
Practice Address - Fax:740-532-6082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH11331C2471C3401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471C3401XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistComputed TomographyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2528769Medicaid
DC9056OtherRR MEDICARE GROUP
P00197531OtherRR MEDICARE PIN
DC9056OtherRR MEDICARE GROUP