Organization
KAN-DI-KI, LLC
Active
Other names
Diagnostic Laboratories, TridentCare
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN C CUOMO (AUTHORIZED OFFICIAL/CFO)
(800) 786-8015
Entity
Organization
Contact information
Practice address
7776 S POINTE PKWY W STE 150, PHOENIX, AZ 85044-5427
(800) 786-8015
Mailing address
215 SCHILLING CIR STE 114, HUNT VALLEY, MD 21031-1113
(800) 786-8015
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
573748
—
AZ
01
—
P00970026
RAILROAD MEDICARE
AZ
Enumeration date
02/18/2010
Last updated
03/11/2026
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