Provider Demographics
NPI:1548352818
Name:RADIOLOGY SPECIALISTS LTD. LLC
Entity type:Organization
Organization Name:RADIOLOGY SPECIALISTS LTD. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:A
Authorized Official - Last Name:KAMPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:216-831-9786
Mailing Address - Street 1:4161 BRIDGEWATER PARKWAY
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224
Mailing Address - Country:US
Mailing Address - Phone:330-920-3770
Mailing Address - Fax:330-920-9770
Practice Address - Street 1:4161 BRIDGEWATER PARKWAY
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224
Practice Address - Country:US
Practice Address - Phone:330-920-3770
Practice Address - Fax:330-920-9770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2012-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0809IC261QM1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2307257Medicaid
OHRAIDO1211Medicare ID - Type Unspecified