# CINCINNATI PET SCAN, LLC

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

## Provider details

- **NPI number:** 1851407217
- **Authorized official:** JOHN MATTES (PRESIDENT)
- **Authorized official phone:** (513) 791-9959

## Contact information

- **Practice address:** 5575 CHEVIOT ROAD, WESTSIDE CT CENTER, CINCINNATI, OH 45247
- **Practice address phone:** (513) 385-8994
- **Practice address fax:** (513) 385-3994
- **Mailing address:** 5575 CHEVIOT ROAD, WESTSIDE CT CENTER, CINCINNATI, OH 45247
- **Mailing address phone:** (513) 385-8994
- **Mailing address fax:** (513) 385-3994

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0200X | Radiology Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/21/2006
- **Last updated:** 08/22/2020