Tri County Imaging Assoc. LTD

Organization Active NPI Diagnostic Radiology Physician · Everett, PA

NPI 1083698484 · NPPES record last updated Apr 30, 2014

Key facts

NPI
1083698484
Entity type
Organization (NPI type 2)
Primary specialty
Diagnostic Radiology Physician 2085R0202X
Legal business name
TRI COUNTY IMAGING ASSOC. LTD
Practice address
10455 Lincoln Hwy
Everett, PA 15537-7046
Phone
(814) 444-1918
Fax
(814) 444-9782
NPI assigned
Nov 30, 2005
Organization subpart
No

Authorized official

Name
Jackie Watts
Title
Office Administrator
Phone
(814) 444-1918

National Provider Directory

Locations

1009 Old Route 119
Hunker, PA 15639
Phone (724) 547-5881

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
2085R0202X Yes

Addresses

Primary practice location

10455 Lincoln Hwy
Everett, PA 15537-7046

Mailing address

PO Box 1198
Somerset, PA 15501-0336
Phone (814) 444-1918

Other identifiers

IdentifierTypeStateIssuer
0011325600010MedicaidPA
526016OtherPAHIGHMARK BLUE SHIELD
106739OtherPAUPMC
1509635MedicaidPA
000000063834MedicaidPA
699866600MedicaidMD
0113399000OtherPAPERSONAL CHOICE

Other providers in Everett, PA

All providers in Everett, PA · Diagnostic Radiology Physician in Pennsylvania

Sources for this page

Verify at the official NPI Registry.