Organization
PROVIDENCE HEALTH SERVICES, INC
Active
Other names
The Providence Diagnostic Imaging Center
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL DUNWELL (COORD CREDENTIALING)
(202) 854-4069
Entity
Organization
Contact information
Practice address
1150 VARNUM ST NE STE 1, WASHINGTON, DC 20017-2104
(202) 854-7560
(202) 854-7951
Mailing address
1150 VARNUM ST NE, WASHINGTON, DC 20017-2180
(202) 854-4069
(202) 854-7825
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
—
—
261QR0200X
Radiology Clinic/Center
—
—
261QR0206X
Mammography Clinic/Center
—
—
293D00000X
Physiological Laboratory
Primary
—
—
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
—
—
Other
Enumeration date
09/03/2019
Last updated
05/06/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us