Provider Demographics
NPI:1841472958
Name:SUPERIOR CARDIAC IMAGING LLC
Entity type:Organization
Organization Name:SUPERIOR CARDIAC IMAGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:MCLENDON
Authorized Official - Suffix:
Authorized Official - Credentials:CCT
Authorized Official - Phone:610-419-9750
Mailing Address - Street 1:PO BOX 517
Mailing Address - Street 2:
Mailing Address - City:HAZLETON
Mailing Address - State:PA
Mailing Address - Zip Code:18201-0517
Mailing Address - Country:US
Mailing Address - Phone:570-450-6200
Mailing Address - Fax:570-450-6207
Practice Address - Street 1:502 E 4TH ST
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18015-1882
Practice Address - Country:US
Practice Address - Phone:610-419-9750
Practice Address - Fax:610-419-9751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-30
Last Update Date:2007-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA3754078246W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246W00000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, CardiologyGroup - Single Specialty