SOURCE DIAGNOSTICS OF PENNSYLVANIA, LLC (NPI# 1053619775) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053619775 |
| Entity Type | Organization |
| Organization Name | SOURCE DIAGNOSTICS OF PENNSYLVANIA, LLC |
| Practice Address |
175 Snyder Rd Hermitage PA 16148-3431 |
| Mailing Address |
5275 Naiman Pkwy Suite E Solon OH 44139-1029 |
| Practice Telephone | 4406457822 |
| Practice Fax Number | 4405429482 |
| Mailing Telephone | 4406457822 |
| Mailing Fax Number | 4405429482 |
| Enumeration Date | 2011-03-03 |
| Last Update Date | 2012-04-12 |
| Authorized Official Name | MS. KATHLEEN ANN BARRY (C.O.O.) |
| Authorized Official Telephone | 4406457822 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346507019 | Source Diagnostics of Pennsylvania, LLC | Clinic/Center | 175 Snyder Rd, Hermitage, PA 16148-3431 | 2012-04-18 |
| Street Address |
175 SNYDER RD |
| City | HERMITAGE |
| State | PA |
| Zip Code | 16148-3431 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396180113 | John Love | Pharmacist | 175 Snyder Rd, Hermitage, PA 16148-3431 | 2013-05-07 |
| 1346507019 | Source Diagnostics of Pennsylvania, LLC | Clinic/Center | 175 Snyder Rd, Hermitage, PA 16148-3431 | 2012-04-18 |
| 1235132721 | Pmc Ohio LLC | Pharmacy | 175 Snyder Rd, Hermitage, PA 16148 | 2005-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518571165 | Cassandra L Holder | Physical Therapist | 1559 N. Hermitage Rd, Hermitage, PA 16148 | 2020-09-01 |
| 1750927190 | Hermitage Endoscopy Center Inc | Clinic/Center | 949 N Hermitage Road, Hermitage, PA 16148 | 2019-11-20 |
| 1336791318 | Catlyn Marie Joseph | Pharmacist | 1851 East State St, Rite Aid Store #10995, Hermitage, PA 16148 | 2019-07-10 |
| 1386203107 | Kaitlyn Mostard-smith | Physical Therapist | 1599 N. Hermitage Rd., Hermitage, PA 16148 | 2019-06-06 |
| 1770001513 | Lee Ann Hougelman | Licensed Practical Nurse | 5454 E. State St., Hermitage, PA 16148 | 2017-08-31 |
| 1194245001 | Samantha C Kilar | Audiologist | 1623 Dutch Lane, Hermitage, PA 16148 | 2017-06-21 |
| 1538419197 | Sharon Lynn Taylor | Physician Assistant | 480 N Kerrwood Dr Ste 103, Hermitage, PA 16148 | 2012-09-11 |
| 1912289638 | Amanda Jo Kline | Physical Therapy Assistant | 260 S Buhl Farm Drive, Whispering Oaks Suite 326, Hermitage, PA 16148 | 2011-09-20 |
| 1447548573 | Robert Joseph Jackson | Licensed Practical Nurse | 5454 East State St, Hermitage, PA 16148 | 2011-07-11 |
| 1386974673 | Susan Dawn Mehallick | Specialist/Technologist | 1005 Campus Circle, Hermitage, PA 16148 | 2010-01-08 |
| Find all providers in zip 16148 | ||||
| Taxonomy Code | 335V00000X |
| Grouping | Suppliers |
| Classification | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier |
| A supplier that provides one or more of the following portable services, including but not limited to, x-ray, electrocardiogram (EKG), long-term EKG (Holter Monitor), bone densitometry, sonography, and other imaging services in accordance with all state and federal requirements, under the general supervision of a qualified physician. All necessary resources are transported to the patient's location where the services are performed. |
| Notes: Source: National Uniform Claim Committee, 2015 [1/1/2016: title and definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134677156 | Sphere Mobile Digital Imaging Services LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 3412 Bluestone Ln, East Stroudsburg, PA 18301-8116 | 2016-09-19 |
| 1801343660 | Preventive Diagnostics Inc | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 7300 Frankford Ave, Philadelphia, PA 19136-4305 | 2016-09-08 |
| 1285087288 | Tri State Imaging Solutions LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 2840 Pine Rd Suite D1, Huntingdon Valley, PA 19006-4258 | 2016-07-14 |
| 1639439003 | Sky Mobile Digital Imaging LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 194 Daffodil Dr, East Stroudsburg, PA 18301-9355 | 2012-05-20 |
| 1699076208 | Pmx Diagnostics Inc | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 501 Gainsboro Rd, Drexel Hill, PA 19026-1213 | 2010-11-12 |
| 1558678227 | Galaxy Mobile Diagnostic Services LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 719 Blue Mountain Lk, East Stroudsburg, PA 18301-7905 | 2010-09-01 |
| 1144472697 | Practice Optimization Partners LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | Rr 2 Box 2183, Factoryville, PA 18419-9621 | 2008-10-15 |
| 1538339718 | Osborne Mobile Diagnostic Services | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 3502 Shadewell Ave, Brentwood, PA 15227-2926 | 2008-03-04 |
| 1316083595 | Physician's Mobile X-ray, Inc. | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 945 E Park Dr, Ste 102, Harrisburg, PA 17111-2804 | 2007-01-29 |
| 1841357902 | Radtech Solutions, LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 1 Springside Ct, Yardley, PA 19067-3594 | 2007-01-01 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.