Provider Demographics
NPI:1497733554
Name:HIGH POINT RADIOLOGICAL SERVICES
Entity Type:Organization
Organization Name:HIGH POINT RADIOLOGICAL SERVICES
Other - Org Name:LEXINGTON DIAGNOSTIC IMAGING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:J
Authorized Official - Last Name:HOLLAND
Authorized Official - Suffix:
Authorized Official - Credentials:MBA,MHA
Authorized Official - Phone:336-882-1416
Mailing Address - Street 1:PO BOX 5007
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-5007
Mailing Address - Country:US
Mailing Address - Phone:336-882-1416
Mailing Address - Fax:336-882-8264
Practice Address - Street 1:1208 EASTCHESTER DR
Practice Address - Street 2:SUITE 200
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-3170
Practice Address - Country:US
Practice Address - Phone:336-882-1416
Practice Address - Fax:336-882-8264
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-08
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC01785OtherBCBSNC
NC8901785Medicaid
NC01785OtherBCBSNC