Organization
PHYSICIAN DIAGNOSTIC SERVICES LLC
Active
Other names
PDSHeart
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA MARIE NAUFUL (VICE PRESIDENT, ACCOUNTS RECEIVABLE)
(678) 487-1266
Entity
Organization
Contact information
Practice address
2425 WALL ST SE, CONYERS, GA 30013-6342
(678) 487-1266
(240) 371-8541
Mailing address
2425 WALL ST SE, CONYERS, GA 30013-6342
(678) 487-1266
(240) 371-8541
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019144200
—
MN
Enumeration date
07/15/2005
Last updated
04/29/2008
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