Provider Demographics
NPI:1922528595
Name:ADVANTAGE IMAGING, LLC
Entity Type:Organization
Organization Name:ADVANTAGE IMAGING, LLC
Other - Org Name:ADVANTAGE DIAGNOSTICS OF COLUMBUS NORTH
Other - Org Type:Other Name
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:WESTRICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-292-9998
Mailing Address - Street 1:3733 PARK EAST DR STE 100
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4334
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1120 POLARIS PKWY STE 105
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43240-4042
Practice Address - Country:US
Practice Address - Phone:614-721-7400
Practice Address - Fax:614-721-7474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-23
Last Update Date:2017-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty