Provider Demographics
NPI:1659320612
Name:DIAGNOSTIC HEALTH CORPORATION
Entity Type:Organization
Organization Name:DIAGNOSTIC HEALTH CORPORATION
Other - Org Name:DIAGNOSTIC HEALTH, BATON ROUGE NORTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:A
Authorized Official - Last Name:PELKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-981-4848
Mailing Address - Street 1:22 INVERNESS CENTER PKWY
Mailing Address - Street 2:SUITE 425
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-4814
Mailing Address - Country:US
Mailing Address - Phone:205-981-4848
Mailing Address - Fax:205-994-7018
Practice Address - Street 1:8416 CUMBERLAND PL
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-6543
Practice Address - Country:US
Practice Address - Phone:225-927-3324
Practice Address - Fax:225-262-8654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1942651Medicaid
LA1942651Medicaid