Provider Demographics
NPI:1326695479
Name:PROSCAN IMAGING OF GREENWOOD, LLC
Entity Type:Organization
Organization Name:PROSCAN IMAGING OF GREENWOOD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:E
Authorized Official - Last Name:AMAYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-924-5174
Mailing Address - Street 1:965 EMERSON PKWY STE E
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-6274
Mailing Address - Country:US
Mailing Address - Phone:317-884-7484
Mailing Address - Fax:317-884-7494
Practice Address - Street 1:965 EMERSON PKWY STE E
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-6274
Practice Address - Country:US
Practice Address - Phone:317-884-7484
Practice Address - Fax:317-884-7494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-23
Last Update Date:2019-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty