Source Diagnostics of Pennsylvania, LLC

Primary specialty

Mobile Radiology Clinic/CenterTaxonomy code 261QR0208X

Legal business name

SOURCE DIAGNOSTICS OF PENNSYLVANIA, LLC

Practice address

175 Snyder Rd
Hermitage, PA 16148-3431

Phone

(866) 512-1515

NPI assigned

Apr 18, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kathleen A Barry

Title

Coo

Phone

(440) 645-7822

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1334707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334707200000",
    "number": "1346507019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5275 NAIMAN PKWY",
            "address_2": "STE E",
            "city": "SOLON",
            "state": "OH",
            "postal_code": "441391029",
            "telephone_number": "886-512-1515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 SNYDER RD",
            "city": "HERMITAGE",
            "state": "PA",
            "postal_code": "161483431",
            "telephone_number": "866-512-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOURCE DIAGNOSTICS OF PENNSYLVANIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-18",
        "last_updated": "2012-04-18",
        "status": "A",
        "authorized_official_last_name": "BARRY",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "440-645-7822"
    },
    "taxonomies": [
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vita Smith, MA
• Tyler H Snodgrass, DC
• Walter John Sokac Jr., OTR
• Sole Solutions Podiatry LTD
• Source Diagnostics of Pennsylvania, LLC
• Dale F Spadafora, DMD
• Specialty Orthopaedics PC PT
• Specialty Orthopaedics, P.C. (Robert W. Piston, M.D., P.C.)
• Specialty Orthopaedics, PC OT
• Jennifer Springborn, R.D.

• Mobile Radiology Clinic/Center in Hermitage, PA
• Providers in Hermitage, PA by specialty
• Mobile Radiology Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.