Provider Demographics
NPI:1356396113
Name:ADVANCED IMAGING CENTER AT DSI BUCKS COUNTY LLC
Entity type:Organization
Organization Name:ADVANCED IMAGING CENTER AT DSI BUCKS COUNTY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EVP CHIEF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEFKOVITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-467-0128
Mailing Address - Street 1:511 UNION STREET
Mailing Address - Street 2:SUITE 1800
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:34219
Mailing Address - Country:US
Mailing Address - Phone:615-467-0134
Mailing Address - Fax:615-234-3504
Practice Address - Street 1:3260 TILLMAN DRIVE
Practice Address - Street 2:SUITE 120
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020
Practice Address - Country:US
Practice Address - Phone:215-639-9604
Practice Address - Fax:215-639-9607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mammography
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
105424Medicare Oscar/Certification