Organization
EXCELA RCL PET CT IMAGING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD WILLIAM CARUSO (SECRETARY TREASURER)
(724) 832-4030
Entity
Organization
Contact information
Practice address
2000 VILLAGE DRIVE, GREENSBURG, PA 15601
(724) 836-0637
(724) 836-0641
Mailing address
7 ACEE DRIVE, NATRONA HEIGHTS, PA 15065
(800) 223-5544
(724) 294-3206
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1014980410001
MEDICAL ASSISTANCE
—
05
—
1014980410001
—
PA
01
—
1548932
GATEWAY
—
01
—
5447LA
MISYS FAST CLAIM
—
01
—
9867791
CIGNA
—
Enumeration date
06/07/2006
Last updated
08/22/2020
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