Provider Demographics
NPI:1609102565
Name:ASHLAND CARDIAC IMAGING, LLC
Entity Type:Organization
Organization Name:ASHLAND CARDIAC IMAGING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:REGINALD
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:SIPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-274-2844
Mailing Address - Street 1:1205 MONTGOMERY AVE
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-2669
Mailing Address - Country:US
Mailing Address - Phone:336-274-2844
Mailing Address - Fax:
Practice Address - Street 1:700 N EUGENE ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1622
Practice Address - Country:US
Practice Address - Phone:336-274-2844
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-28
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No2471C3401XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistComputed TomographyGroup - Multi-Specialty