Provider Demographics
NPI:1194825240
Name:LUMINIS HEALTH IMAGING, INC.
Entity Type:Organization
Organization Name:LUMINIS HEALTH IMAGING, INC.
Other - Org Name:ANNE ARUNDEL HEALTH CARE SERVICES,INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-481-5335
Mailing Address - Street 1:PO BOX 404433
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-4433
Mailing Address - Country:US
Mailing Address - Phone:804-756-5130
Mailing Address - Fax:804-672-6899
Practice Address - Street 1:4175 N HANSON CT
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-3179
Practice Address - Country:US
Practice Address - Phone:301-464-0798
Practice Address - Fax:301-464-8410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2085R0202X
NA261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD764801410Medicaid
DCG01780OtherMEDICARE GROUP DC LOCAL
MD1073OtherCAREFIRST DC
MDCK4885OtherRAILROAD MEDICARE
MDS645ANOtherCAREFIRST MARYLAND