Provider Demographics
NPI:1023066438
Name:DIAGNOSTIC HEALTH CORPORATION
Entity type:Organization
Organization Name:DIAGNOSTIC HEALTH CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BURCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-685-5075
Mailing Address - Street 1:1001 S KIRKWOOD RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:KIRKWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63122-7254
Mailing Address - Country:US
Mailing Address - Phone:314-821-9173
Mailing Address - Fax:314-821-6157
Practice Address - Street 1:1001 S KIRKWOOD RD
Practice Address - Street 2:SUITE 110
Practice Address - City:KIRKWOOD
Practice Address - State:MO
Practice Address - Zip Code:63122-7254
Practice Address - Country:US
Practice Address - Phone:314-821-9173
Practice Address - Fax:314-821-6157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO93031Medicare ID - Type UnspecifiedIDTF