Provider Demographics
NPI:1982997391
Name:ACCUSCAN MEDICAL IMAGING, LLC
Entity Type:Organization
Organization Name:ACCUSCAN MEDICAL IMAGING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED AGENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:ROVNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-965-6850
Mailing Address - Street 1:6765 MOULTON PL
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-6513
Mailing Address - Country:US
Mailing Address - Phone:678-965-6850
Mailing Address - Fax:
Practice Address - Street 1:6765 MOULTON PL
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-6513
Practice Address - Country:US
Practice Address - Phone:678-965-6850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-17
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory