National Provider Identifier Database

SOURCE DIAGNOSTICS LLC
Radiologic Technologist

A medical imaging or radiation therapy professional who is appropriately educated and trained to perform medical imaging procedures using ionizing and nonionizing radiation.


Contact Information

SOURCE DIAGNOSTICS LLC
5275 NAIMAN PKWY
STE E
SOLON, OH44139-1029
Phone: 440-542-1515
Fax: 440-542-9482
Website:
Specialty Taxonomy Code
* Radiologic Technologist 247100000X
Technician, Cardiology 246W00000X

* Indicates primary specialty

NPI Profile & details for SOURCE DIAGNOSTICS LLC

NPI Number 1386698470
Legal business name
LBN
SOURCE DIAGNOSTICS LLC
Authorized official KEITH MARCHAND - (PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 05/22/2006
Last updated 03/08/2012 - About 14 years ago
Sole proprietor1 Not specified
Identifiers
  • OH License #: OH03645
  • OH Medicaid: 2538052

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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