Provider Demographics
NPI:1780680017
Name:RENO RADIOLOGICAL ASSOCIATES, CHARTERED
Entity Type:Organization
Organization Name:RENO RADIOLOGICAL ASSOCIATES, CHARTERED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:R
Authorized Official - Last Name:BEIDLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:775-376-8379
Mailing Address - Street 1:PO BOX 39000
Mailing Address - Street 2:DEPT 34548
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94139
Mailing Address - Country:US
Mailing Address - Phone:775-376-8379
Mailing Address - Fax:
Practice Address - Street 1:1155 MILL ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1576
Practice Address - Country:US
Practice Address - Phone:775-982-8100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-22
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1227OtherRAILROAD MEDICARE
NV100500512Medicaid
CT1227OtherRAILROAD MEDICARE
NVVWCHBBMedicare PIN