Source Diagnostics, LLC

Primary specialty

Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X

Legal business name

SOURCE DIAGNOSTICS, LLC

Practice address

7581 Secor Rd
Lambertville, MI 48144-9624

Phone

(440) 645-7822

NPI assigned

Jun 3, 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": "1338681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338681600000",
    "number": "1871854265",
    "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": "440-645-7822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7581 SECOR RD",
            "city": "LAMBERTVILLE",
            "state": "MI",
            "postal_code": "481449624",
            "telephone_number": "440-645-7822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOURCE DIAGNOSTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-03",
        "last_updated": "2012-06-03",
        "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": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Lambertville, MI
• Providers in Lambertville, MI by specialty
• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.