Provider Demographics
NPI:1346029634
Name:PRIORITY IMAGING CORP
Entity Type:Organization
Organization Name:PRIORITY IMAGING CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ISSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-575-8557
Mailing Address - Street 1:10551 ALLEN RD STE 107A
Mailing Address - Street 2:
Mailing Address - City:ALLEN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48101-1159
Mailing Address - Country:US
Mailing Address - Phone:313-406-4849
Mailing Address - Fax:
Practice Address - Street 1:10551 ALLEN RD STE 107A
Practice Address - Street 2:
Practice Address - City:ALLEN PARK
Practice Address - State:MI
Practice Address - Zip Code:48101-1159
Practice Address - Country:US
Practice Address - Phone:313-406-4849
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center