St Elizabeth Southwoods Imaging LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

License

0056IC Issued in OH

Legal business name

ST ELIZABETH SOUTHWOODS IMAGING LLC

Doing business as

Southwoods Imaging Center

Practice address

250 Debartolo PL
BLDG B
Youngstown, OH 44512-7004

Phone

(330) 726-2595

Fax

(330) 726-3249

NPI assigned

Feb 6, 2008

Last updated

Feb 6, 2008By 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

Mr. James E Fulciniti, CPA

Title

Treasurer

Phone

(330) 729-0357

Specialties & licenses 1

Addresses

Other names 1

• Southwoods Imaging Center Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Mercy Health Youngstown LLC

  dba Mercy Health Youngstown Laboratory

  • Clinical Medical Laboratory
  • Youngstown, OH
  • NPI 1831600295

  Member Of

  NPD member

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

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202256000000",
    "number": "1477731073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 DEBARTOLO PL",
            "address_2": "BLDG B",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445127004",
            "telephone_number": "330-726-2595",
            "fax_number": "330-726-3249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 DEBARTOLO PL",
            "address_2": "BLDG B",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445127004",
            "telephone_number": "330-726-2595",
            "fax_number": "330-726-3249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST ELIZABETH SOUTHWOODS IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-06",
        "last_updated": "2008-02-06",
        "status": "A",
        "authorized_official_last_name": "FULCINITI",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "330-729-0357",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "OH",
            "license": "0056IC",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southwoods Imaging Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Greg Squibbs
• Jennifer Lynn Squibbs, MSN, CRNA
• Laura Mae Squibbs
• Kelsey Squires
• St Elizabeth Health Center
• Sara St. Clair, LPN
• St. Elizabeth Cardiac Cath Lab, LLC (The Heart Lab at St. Elizabeth's)
• St. Elizabeth Cardiac Cath Lab, LLC (The Heart Lab at St. Elizabeth's)
• St. Elizabeth Health Center
• Tameika Cincere St. Thomas, RN

• Radiology Clinic/Center in Youngstown, OH
• Providers in Youngstown, 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 Feb 6, 2008; 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.