Provider Demographics
NPI:1891973921
Name:MERIDIAN IMAGING CENTER, LLC
Entity Type:Organization
Organization Name:MERIDIAN IMAGING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:DISBROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-432-5438
Mailing Address - Street 1:3455 MILL RUN DR
Mailing Address - Street 2:SUITE 450
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-9078
Mailing Address - Country:US
Mailing Address - Phone:614-771-2229
Mailing Address - Fax:614-771-2221
Practice Address - Street 1:6850 PERIMETER DR
Practice Address - Street 2:SUITE C
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-8051
Practice Address - Country:US
Practice Address - Phone:614-771-2229
Practice Address - Fax:614-771-2221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-31
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPENDING261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology