Provider Demographics
NPI:1871947184
Name:DANVILLE DIAGNOSTIC IMAGING CENTER, LLC
Entity type:Organization
Organization Name:DANVILLE DIAGNOSTIC IMAGING CENTER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:TERRANCE
Authorized Official - Middle Name:
Authorized Official - Last Name:DILLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-596-7220
Mailing Address - Street 1:19144 US HIGHWAY 29
Mailing Address - Street 2:SUITE C
Mailing Address - City:CHATHAM
Mailing Address - State:VA
Mailing Address - Zip Code:24531-5548
Mailing Address - Country:US
Mailing Address - Phone:434-793-1043
Mailing Address - Fax:434-799-0202
Practice Address - Street 1:19144 US HIGHWAY 29
Practice Address - Street 2:SUITE C
Practice Address - City:CHATHAM
Practice Address - State:VA
Practice Address - Zip Code:24531-5548
Practice Address - Country:US
Practice Address - Phone:434-793-1043
Practice Address - Fax:434-799-0202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-22
Last Update Date:2022-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology