Provider Demographics
NPI:1417243791
Name:NEVES IMAGING SPECIALISTS, LLC
Entity Type:Organization
Organization Name:NEVES IMAGING SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:PENNY
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:HEAVILON
Authorized Official - Suffix:
Authorized Official - Credentials:RVT, RT(R)(M)
Authorized Official - Phone:317-780-8935
Mailing Address - Street 1:1003 CHARNWOOD PKWY
Mailing Address - Street 2:
Mailing Address - City:BEECH GROVE
Mailing Address - State:IN
Mailing Address - Zip Code:46107-3307
Mailing Address - Country:US
Mailing Address - Phone:317-780-8935
Mailing Address - Fax:
Practice Address - Street 1:1003 CHARNWOOD PKWY
Practice Address - Street 2:
Practice Address - City:BEECH GROVE
Practice Address - State:IN
Practice Address - Zip Code:46107-3307
Practice Address - Country:US
Practice Address - Phone:317-780-8935
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-24
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier