Organization
DENRIC COLUMBUS EAST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENY RADEFELD (CEO)
(254) 933-9351
Entity
Organization
Contact information
Practice address
6465 E BROAD ST, STE 210, COLUMBUS, OH 43213-1576
(614) 860-0930
Mailing address
PO BOX 633849, CINCINNATI, OH 45263-3849
(866) 287-3726
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000297527
BC/BS GROUP PIN NUMBER
OH
05
—
2550556
—
OH
01
—
P00134356
RR MEDICARE NUMBER
OH
Enumeration date
07/08/2005
Last updated
07/21/2022
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