Provider Demographics
NPI:1679526800
Name:E PLUS PET IMAGING XVIII LP
Entity Type:Organization
Organization Name:E PLUS PET IMAGING XVIII LP
Other - Org Name:PET IMAGING OF NORTHERN COLORADO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO OF GENERAL PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:RHYMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-467-7415
Mailing Address - Street 1:1915 WILMINGTON DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528-3008
Mailing Address - Country:US
Mailing Address - Phone:970-204-0202
Mailing Address - Fax:970-204-0208
Practice Address - Street 1:1915 WILMINGTON DR
Practice Address - Street 2:SUITE 101
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-3008
Practice Address - Country:US
Practice Address - Phone:970-204-0202
Practice Address - Fax:970-204-0208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1679526800Medicaid
COC804621Medicare PIN