Provider Demographics
NPI:1053361410
Name:LANCASTER MAGNETIC IMAGING, LTD
Entity type:Organization
Organization Name:LANCASTER MAGNETIC IMAGING, LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERI
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-685-5000
Mailing Address - Street 1:2764 PELHAM PKWY
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124-1702
Mailing Address - Country:US
Mailing Address - Phone:205-685-5053
Mailing Address - Fax:205-994-7039
Practice Address - Street 1:213 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-3364
Practice Address - Country:US
Practice Address - Phone:717-394-2693
Practice Address - Fax:717-397-2679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA022281Medicare PIN