Provider Demographics
NPI:1730266776
Name:TUCSON CARDIOVASCULAR IMAGING LLC
Entity type:Organization
Organization Name:TUCSON CARDIOVASCULAR IMAGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE SUPERVISOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:AURIELLE
Authorized Official - Middle Name:SUZAN
Authorized Official - Last Name:FLASSCHOEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-325-4198
Mailing Address - Street 1:PO BOX 43100
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85733-3100
Mailing Address - Country:US
Mailing Address - Phone:520-722-3777
Mailing Address - Fax:520-296-6224
Practice Address - Street 1:4790 E CAMP LOWELL DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-1275
Practice Address - Country:US
Practice Address - Phone:520-325-4198
Practice Address - Fax:520-881-3220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QR0200X
AZAZ18426207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiologyGroup - Multi-Specialty
Not Answered207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
2Z8736OtherHEALTHNET
AZ0409660OtherBCBS
2Z8736OtherHEALTHNET
AZ0409660OtherBCBS