Organization
RADIOLOGY IMAGING ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACEANN GRILLO (CREDENTIALING SUPERVISOR)
(720) 493-3716
Entity
Organization
Contact information
Practice address
10800 E GEDDES AVE STE 300, ENGLEWOOD, CO 80112-3895
(303) 761-9190
(720) 874-4462
Mailing address
10800 E GEDDES AVE, ENGLEWOOD, CO 80112-3894
(303) 761-9190
(720) 874-4462
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000901750 0003
—
PA
05
—
0560060
—
IA
05
—
074088802
—
TX
05
—
100006790A
—
IN
05
—
100370940B
—
KS
05
—
107475000
—
WY
05
—
1528962
—
TN
05
—
1679513196
—
ID
05
—
1679513196
—
MT
05
—
196643002
—
AR
01
—
201053620
PRES SALUD MEDICAID
—
05
—
4220042
—
CO
05
—
695538
—
AZ
01
—
8161045
AETNA RIA
—
01
—
CD2044
RR MEDICARE RIA
—
01
—
CO1609
HEALTHNET NE RIA
—
05
—
G9020
—
NM
05
—
MPG0457
—
AK
05
—
QPB657
—
SC
01
—
RA22004
BCBS RIA
—
Enumeration date
06/07/2006
Last updated
03/31/2024
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