Organization
EXTENDED CARE DIAGNOSTICS LLC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE GANOTE (OPERTIONS MANAGER)
(317) 557-6165
Entity
Organization
Contact information
Practice address
4422 CARVER WOODS DR STE 6, BLUE ASH, OH 45242-5536
(513) 891-3181
(513) 891-3934
Mailing address
4422 CARVER WOODS DR STE 6, BLUE ASH, OH 45242-5536
(513) 891-3181
(513) 891-3934
Taxonomy
Speciality
Code
Description
License number
State
261QR0208X
Mobile Radiology Clinic/Center
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2161315
—
OH
01
—
630001723
RR MEDICARE
OH
Enumeration date
02/08/2007
Last updated
02/14/2012
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