Provider Demographics
NPI:1275574576
Name:RADIOLOGY SERVICES CORPORATION
Entity Type:Organization
Organization Name:RADIOLOGY SERVICES CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DOREN
Authorized Official - Middle Name:D
Authorized Official - Last Name:RHOADES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-687-3553
Mailing Address - Street 1:PO BOX 9023
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67277-0023
Mailing Address - Country:US
Mailing Address - Phone:316-387-3553
Mailing Address - Fax:316-440-3344
Practice Address - Street 1:1313 S YOUNG ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67209-2629
Practice Address - Country:US
Practice Address - Phone:316-687-3553
Practice Address - Fax:316-440-3344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100291570AMedicaid
KS100291570AMedicaid