Provider Demographics
NPI:1275283053
Name:BTDI JV LLP
Entity Type:Organization
Organization Name:BTDI JV LLP
Other - Org Name:TOUCHSTONE IMAGING ROCKWALL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROELLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-689-1691
Mailing Address - Street 1:PO BOX 746003
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6003
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:901 ROCKWALL PKWY
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-6502
Practice Address - Country:US
Practice Address - Phone:469-897-5660
Practice Address - Fax:469-897-5661
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BTDI JV LLP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-03-25
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory