Organization
JEFFERSON UNIVERSITY RADIOLOGY ASSOCIATES, LLC
Active
Parent organization
JEFFERSON UNIVERSITY RADIOLOGY ASSOCIATES, LLC
Other names
Jefferson Outpatient Imaging
Organization subpart
Yes
Provider details
NPI number
Legal business name
JEFFERSON UNIVERSITY RADIOLOGY ASSOCIATES, LLC
Authorized official
AMY STOUT (PRESIDENT/CEO)
(615) 261-2306
Entity
Organization
Contact information
Practice address
1 W GERMANTOWN PIKE, EAST NORRITON, PA 19401-1513
(615) 277-3202
(610) 277-9640
Mailing address
800 CRESCENT CENTRE DR STE 400, FRANKLIN, TN 37067-7270
(615) 261-2306
(855) 588-3545
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
293D00000X
Physiological Laboratory
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
205517
MEDICARE IDTF (MOBILE PET/CT)
PA
01
—
255184
MEDICARE IDTF (MOBILE PET/CT)
NJ
Enumeration date
09/21/2010
Last updated
10/21/2024
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