Provider Demographics
NPI:1457300451
Name:DIAGNOSTIC HEALTH CORPORATION
Entity Type:Organization
Organization Name:DIAGNOSTIC HEALTH CORPORATION
Other - Org Name:HEALTHSOUTH DIAG. CTR - TENAYA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERI
Authorized Official - Middle Name:K
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-685-5116
Mailing Address - Street 1:2650 N TENAYA WAY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-1102
Mailing Address - Country:US
Mailing Address - Phone:702-952-3640
Mailing Address - Fax:702-952-3699
Practice Address - Street 1:2650 N TENAYA WAY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-1102
Practice Address - Country:US
Practice Address - Phone:702-952-3640
Practice Address - Fax:702-952-3699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV34035Medicare ID - Type UnspecifiedIDTF