Provider Demographics
NPI: | 1235188608 |
---|---|
Name: | DIAGNOSTIC HEALTH CORPORATION |
Entity Type: | Organization |
Organization Name: | DIAGNOSTIC HEALTH CORPORATION |
Other - Org Name: | HEALTHSOUTH DIAGNOSTIC CENTER OF PARK CITY |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | CREDENTIALING SPECIALIST |
Authorized Official - Prefix: | |
Authorized Official - First Name: | DONNA |
Authorized Official - Middle Name: | L |
Authorized Official - Last Name: | BURCH |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 866-685-5001 |
Mailing Address - Street 1: | 1850 SIDEWINDER DR |
Mailing Address - Street 2: | SUITE 410 |
Mailing Address - City: | PARK CITY |
Mailing Address - State: | UT |
Mailing Address - Zip Code: | 84060-7471 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 435-615-0250 |
Mailing Address - Fax: | 435-615-0252 |
Practice Address - Street 1: | 1850 SIDEWINDER DR |
Practice Address - Street 2: | SUITE 410 |
Practice Address - City: | PARK CITY |
Practice Address - State: | UT |
Practice Address - Zip Code: | 84060-7471 |
Practice Address - Country: | US |
Practice Address - Phone: | 435-615-0250 |
Practice Address - Fax: | 435-615-0252 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-05-10 |
Last Update Date: | 2020-08-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 293D00000X | Laboratories | Physiological Laboratory |