Premium Diagnostics Center LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

PREMIUM DIAGNOSTICS CENTER LLC

Doing business as

Women's Diagnostic Clinic

Practice address

5319 Hoag Dr
Sheffield Village, OH 44035-1494

Phone

(440) 930-6020

NPI assigned

Jun 28, 2010

Last updated

Jun 29, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Kari Dlugosz

Title

Manager

Phone

(440) 930-6020

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Women's Diagnostic Clinic Doing business as

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

{
    "created_epoch": "1277683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277769600000",
    "number": "1467763169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 417",
            "city": "AVON",
            "state": "OH",
            "postal_code": "440110417",
            "telephone_number": "440-930-6020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5319 HOAG DR",
            "city": "SHEFFIELD VILLAGE",
            "state": "OH",
            "postal_code": "440351494",
            "telephone_number": "440-930-6020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIUM DIAGNOSTICS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-28",
        "last_updated": "2010-06-29",
        "status": "A",
        "authorized_official_last_name": "DLUGOSZ",
        "authorized_official_first_name": "KARI",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "440-930-6020",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2154350",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Women's Diagnostic Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Radiology Clinic/Center in Sheffield Village, OH
• Providers in Sheffield Village, OH by specialty
• Radiology Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2010; 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.