Organization
NATIONAL PET CENTERS LLC
Active
Organization
NATIONAL PET CENTERS LLC
Active
Other names
Great Lakes Medical Imaging
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID L GILLILAND (OWNER)
(336) 274-2844
Entity
Organization
Contact information
Practice address
19250 BAGLEY ROAD, SUITE 203, NATIONAL PET CENTERS LLC DBA GREAT LAKES MEDICAL IMAGIN, MIDDLEBURG HEIGHTS, OH 44130
(440) 234-3321
(440) 234-3323
Mailing address
5313 DONA ROAD, JULIAN, NC 27283
(336) 274-2844
(336) 274-2817
Taxonomy
Speciality
Code
Description
License number
State
2471N0900X
Nuclear Medicine Technology Radiologic Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1093798720
RENDERING PROVIDER NUMBERS
—
01
—
1275583791
RENDERING PROVIDER NUMBER
—
01
—
192232
ANTHEM BLUE SHIELD
—
01
—
192322
ANTHEM BC/BS
—
05
—
2326478
—
OH
Enumeration date
07/04/2006
Last updated
01/13/2011
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up