Organization
PROGRESSIVE WELLNESS IMAGING
Active
Parent organization
PHYSICIANS IMAGING SOLUTIONS II
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHYSICIANS IMAGING SOLUTIONS II
Authorized official
MRS. DIANE S MORENO (GENERAL MANAGER)
(419) 517-1700
Entity
Organization
Contact information
Practice address
7640 SYLVANIA AVE, SUITE A-1, SYLVANIA, OH 43560-9729
(419) 517-1700
(417) 517-1711
Mailing address
7640 SYLVANIA AVE, SUITE A-1, SYLVANIA, OH 43560-9729
(419) 517-1700
(417) 517-1711
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
IOG1038601
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1187-IC
HEALTH CARE FACILITY LIC
OH
05
—
2614648
—
OH
01
—
P00361454
MEDICARE RAILROAD
—
Enumeration date
10/20/2006
Last updated
10/15/2007
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