Provider Demographics
NPI:1649283219
Name:RADIOLOGIC CONSULTANTS, LTD
Entity type:Organization
Organization Name:RADIOLOGIC CONSULTANTS, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:HANULA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-832-8004
Mailing Address - Street 1:717 E PITTSBURGH ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-2636
Mailing Address - Country:US
Mailing Address - Phone:724-832-8004
Mailing Address - Fax:724-837-1870
Practice Address - Street 1:717 E PITTSBURGH ST
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-2636
Practice Address - Country:US
Practice Address - Phone:724-832-8004
Practice Address - Fax:724-837-1870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007167980040Medicaid
PA427895Medicare PIN
PA0007167980040Medicaid