Lakeshore Diagnostics Ultrasound, Co.

Key facts

NPI: 1366740359
Entity type: Organization (NPI type 2)
Primary specialty: Portable X-ray and/or Other Portable Diagnostic Imaging Supplier 335V00000X
Legal business name: LAKESHORE DIAGNOSTICS ULTRASOUND, CO.
Practice address: 1003 Woodside Ave
Essexville, MI 48732-1234
Phone: (989) 892-8444
Fax: (989) 892-7455
NPI assigned: Mar 1, 2011
Organization subpart: No

Authorized official

Name: Mrs. Jennifer J Chislea, RMC
Title: Office Manager
Phone: (989) 892-8444

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier	335V00000X		MI	Yes

Addresses

Primary practice location

1003 Woodside Ave
Essexville, MI 48732-1234

Mailing address

1003 Woodside Ave
Essexville, MI 48732-1234
Phone (989) 892-8444

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 1, 2011.

{
    "created_epoch": "1298937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298937600000",
    "number": "1366740359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 WOODSIDE AVE",
            "city": "ESSEXVILLE",
            "state": "MI",
            "postal_code": "487321234",
            "telephone_number": "989-892-8444",
            "fax_number": "989-892-7455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 WOODSIDE AVE",
            "city": "ESSEXVILLE",
            "state": "MI",
            "postal_code": "487321234",
            "telephone_number": "989-892-8444",
            "fax_number": "989-892-7455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE DIAGNOSTICS ULTRASOUND, CO.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-01",
        "last_updated": "2011-03-01",
        "status": "A",
        "authorized_official_last_name": "CHISLEA",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "989-892-8444",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RMC"
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Essexville, MI

All providers in Essexville, MI · Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Michigan

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 1, 2011. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.