Provider Demographics
NPI:1356499594
Name:RENOWN X-RAY & IMAGING
Entity Type:Organization
Organization Name:RENOWN X-RAY & IMAGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:NOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-823-1999
Mailing Address - Street 1:85 KIRMAN AVE
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1339
Mailing Address - Country:US
Mailing Address - Phone:775-982-5770
Mailing Address - Fax:775-982-5771
Practice Address - Street 1:5250 NEIL RD STE 103
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-6546
Practice Address - Country:US
Practice Address - Phone:775-823-1999
Practice Address - Fax:775-823-1966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVVWCHBBMedicare ID - Type Unspecified