Provider Demographics
NPI:1528003605
Name:ERIE IMAGING, LLC
Entity Type:Organization
Organization Name:ERIE IMAGING, LLC
Other - Org Name:VILLAGE IMAGING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:RICE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:615-661-9200
Mailing Address - Street 1:5214 MARYLAND WAY
Mailing Address - Street 2:STE 200
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5034
Mailing Address - Country:US
Mailing Address - Phone:615-661-9200
Mailing Address - Fax:615-661-9297
Practice Address - Street 1:5473 VILLAGE COMMON DR
Practice Address - Street 2:STE 207
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-4961
Practice Address - Country:US
Practice Address - Phone:814-836-0093
Practice Address - Fax:814-836-0143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA081118Medicare ID - Type UnspecifiedIDTF