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Organization

RCOA IMAGING SERVICES, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DERRICK R MOORE (VP OF ACCOUNTING AND FINANCE)
(561) 477-3500
Entity
Organization

Contact information

Practice address
1008 MINNEQUA AVE, PUEBLO, CO 81004-3733
(866) 293-3500
(866) 293-3535
Mailing address
PO BOX 850001, ORLANDO, FL 32885-0375
(866) 293-3500
(866) 293-3535

Taxonomy

Speciality
Code
Description
License number
State
261QR0208X
Mobile Radiology Clinic/Center
Primary
1005-01
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
663825
ANTHEM BCBS PROVIDER #
CO
Enumeration date
04/11/2006
Last updated
08/22/2020
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