Organization
NORTHWEST RANCHO VISTOSO IMAGING SERVICES LLC
Active
Other names
Southern Arizona Diagnostic Imaging Center
Organization subpart
No
Provider details
NPI number
Authorized official
LAURIE HOLTSFORD (DIRECTOR, BUSINESS OFFICE SERVICES)
(615) 465-7466
Entity
Organization
Contact information
Practice address
1845 W ORANGE GROVE, TUCSON, AZ 85741
(520) 469-8960
Mailing address
PO BOX 36446, TUCSON, AZ 85740-6446
(520) 469-8960
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
OTC-2709
AZ
261QR0200X
Radiology Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
866121
—
AZ
Enumeration date
05/18/2006
Last updated
11/06/2007
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