Provider Demographics
NPI:1568541076
Name:POCONO IMAGING PARTNERS, LLP
Entity Type:Organization
Organization Name:POCONO IMAGING PARTNERS, LLP
Other - Org Name:ADVANCED RADIOLOGY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:T
Authorized Official - Last Name:KEMPF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:570-421-8196
Mailing Address - Street 1:PO BOX 60
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18301-3005
Mailing Address - Country:US
Mailing Address - Phone:570-421-8196
Mailing Address - Fax:570-476-6213
Practice Address - Street 1:400 PLAZA COURT
Practice Address - Street 2:SUITE C
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301-3005
Practice Address - Country:US
Practice Address - Phone:570-420-4100
Practice Address - Fax:570-476-6213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017952590002Medicaid
PA0017952590002Medicaid
=========OtherFIN