Provider Demographics
NPI:1720226616
Name:A1 IMAGING CENTERS LLC
Entity Type:Organization
Organization Name:A1 IMAGING CENTERS LLC
Other - Org Name:A1 IMAGING OF FORT WORTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF MANAGED CARE
Authorized Official - Prefix:
Authorized Official - First Name:TOM
Authorized Official - Middle Name:
Authorized Official - Last Name:COLICCHIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-887-8788
Mailing Address - Street 1:2 N TAMIAMI TRL
Mailing Address - Street 2:SUITE 210
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34236-5574
Mailing Address - Country:US
Mailing Address - Phone:941-925-3490
Mailing Address - Fax:941-953-4452
Practice Address - Street 1:7440 OAKMONT BLVD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-3904
Practice Address - Country:US
Practice Address - Phone:817-294-2400
Practice Address - Fax:817-294-2402
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:A1 IMAGING CENTERS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-01-30
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)