Provider Demographics
NPI:1417298134
Name:COLUMBUS REGIONAL DIAGNOSTICS
Entity Type:Organization
Organization Name:COLUMBUS REGIONAL DIAGNOSTICS
Other - Org Name:ADVANCED IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:JEFFREY
Authorized Official - Last Name:ARMSTRONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-642-1703
Mailing Address - Street 1:500 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:WHITEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28472-3634
Mailing Address - Country:US
Mailing Address - Phone:910-642-8011
Mailing Address - Fax:910-642-9305
Practice Address - Street 1:619 JEFFERSON ST.
Practice Address - Street 2:STE. 2
Practice Address - City:WHITEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28472-3707
Practice Address - Country:US
Practice Address - Phone:910-642-8011
Practice Address - Fax:910-642-9305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-05
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology