# PENSACOLA DIAGNOSTIC RADIOGRAPHY, INC.

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

## Provider details

- **NPI number:** 1629286240
- **Authorized official:** TAMMY GRIFFIN (OWNER)
- **Authorized official phone:** (850) 206-7660

## Contact information

- **Practice address:** 4315 SUGAR MILL BND, PACE, FL 32571-8646
- **Practice address phone:** (850) 206-7660
- **Practice address fax:** (850) 637-8044
- **Mailing address:** 4315 SUGAR MILL BND, PACE, FL 32571-8646
- **Mailing address phone:** (850) 206-7660
- **Mailing address fax:** (850) 637-8044

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | JR3105700 | FL | Yes |

## Other

- **Enumeration date:** 05/18/2007
- **Last updated:** 10/05/2021