Provider Demographics
NPI:1497139216
Name:CT SCANNING CENTER P.L.L.C
Entity Type:Organization
Organization Name:CT SCANNING CENTER P.L.L.C
Other - Org Name:ROCHESTER DIAGNOSTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PIERRE
Authorized Official - Middle Name:CHARBEL
Authorized Official - Last Name:ATALLAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-495-2438
Mailing Address - Street 1:PO BOX 82177
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48308-2177
Mailing Address - Country:US
Mailing Address - Phone:248-651-9200
Mailing Address - Fax:
Practice Address - Street 1:543 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307-1485
Practice Address - Country:US
Practice Address - Phone:248-656-3105
Practice Address - Fax:248-651-0066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-10
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301032954261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology