Provider Demographics
NPI:1891187043
Name:BTDI JV, LLP
Entity Type:Organization
Organization Name:BTDI JV, LLP
Other - Org Name:TOUCHSTONE IMAGING FOREST LANE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:KATE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROELLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-689-1691
Mailing Address - Street 1:PO BOX 746003
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6003
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11617 N CENTRAL EXPY STE 132
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-3853
Practice Address - Country:US
Practice Address - Phone:214-369-3795
Practice Address - Fax:866-225-8389
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BTDI JV, LLP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-02-25
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory