Provider Demographics
NPI:1740038751
Name:FOUNDATION RADIOLOGY GROUP PC
Entity type:Organization
Organization Name:FOUNDATION RADIOLOGY GROUP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RCM BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:RAYMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-230-8361
Mailing Address - Street 1:6400 BROOKTREE CT STE 350
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-9271
Mailing Address - Country:US
Mailing Address - Phone:412-230-8200
Mailing Address - Fax:412-230-8315
Practice Address - Street 1:14999 HEALTH CENTER DR STE 108
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-1079
Practice Address - Country:US
Practice Address - Phone:412-230-8200
Practice Address - Fax:412-230-8315
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FOUNDATION RADIOLOGY GROUP PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear RadiologyGroup - Multi-Specialty