# SCAN HEALTH IMAGING LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073817490
- **Authorized official:** DR. MANNTEJ SRA M.D (OWNER)
- **Authorized official phone:** (623) 815-8200

## Contact information

- **Practice address:** 13943 N 91ST AVE, SUITE 102, PEORIA, AZ 85381-3629
- **Practice address phone:** (623) 815-8200
- **Practice address fax:** (623) 344-5458
- **Mailing address:** 13943 N 91ST AVE, SUITE 102, PEORIA, AZ 85381-3629
- **Mailing address phone:** (623) 815-8200
- **Mailing address fax:** (623) 344-5458

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085R0202X | Diagnostic Radiology Physician | 28033 | AZ | — |
| 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | — | NULL | Yes |

## Other

- **Enumeration date:** 12/28/2010
- **Last updated:** 12/28/2010