Organization
SHARED PET IMAGING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA KASSA (SR VICE PRESIDENT)
(904) 300-2777
Entity
Organization
Contact information
Practice address
1341 CLARK ST, CAMBRIDGE, OH 43725
(330) 491-0480
(330) 491-0488
Mailing address
8300 W SUNRISE BLVD, PLANTATION, FL 33322-5406
Taxonomy
Speciality
Code
Description
License number
State
261QR0208X
Mobile Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200398920
—
IN
05
—
2364392
—
OH
05
—
2410251
—
OH
05
—
2651090
—
OH
Enumeration date
05/24/2005
Last updated
07/24/2023
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