Provider Demographics
NPI:1811933344
Name:TOUCHSTONE IMAGING OF HERMITAGE, LLC
Entity type:Organization
Organization Name:TOUCHSTONE IMAGING OF HERMITAGE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MORELAND
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:615-356-5514
Mailing Address - Street 1:28 WHITE BRIDGE RD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-1499
Mailing Address - Country:US
Mailing Address - Phone:615-356-3999
Mailing Address - Fax:615-353-0462
Practice Address - Street 1:5045 OLD HICKORY BLVD
Practice Address - Street 2:STE 100
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-2582
Practice Address - Country:US
Practice Address - Phone:615-884-7674
Practice Address - Fax:615-884-2696
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2009-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3861157Medicaid
TN3790573Medicare ID - Type UnspecifiedIDTF