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Organization

JEFFERSON REGIONAL PET SCANNING GP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
AL RAGAN (TREASURER)
(412) 205-6095
Entity
Organization

Contact information

Practice address
1200 BROOKS LANE, STE G50, CLAIRTON, PA 15025
(412) 469-8308
(412) 469-8309
Mailing address
1200 BROOKS LANE, STE G50, CLAIRTON, PA 15025
(412) 469-8308
(412) 469-8309

Taxonomy

Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
PA0899
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
135445
UNISON
PA
01
1387329
HIGHMARK
PA
01
188642
HEALTH AMERICA ASSURANCE
PA
01
410453
UPMC
PA
01
800468
FED BLACK LUNG
PA
Enumeration date
04/17/2006
Last updated
08/22/2020
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