Provider Demographics
NPI:1184901944
Name:PARKWAY IMAGING CENTER, LLC
Entity type:Organization
Organization Name:PARKWAY IMAGING CENTER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EVP, REVENUE CYCLE MGT.
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:R
Authorized Official - Last Name:BLANK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-282-6000
Mailing Address - Street 1:26250 ENTERPRISE CT
Mailing Address - Street 2:100
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630-8406
Mailing Address - Country:US
Mailing Address - Phone:949-282-6026
Mailing Address - Fax:
Practice Address - Street 1:100 N GREEN VALLEY PKWY
Practice Address - Street 2:130
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-6391
Practice Address - Country:US
Practice Address - Phone:702-990-7419
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-08
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile