ST ELIZABETH SOUTHWOODS IMAGING LLC (NPI# 1477731073) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477731073 |
| Entity Type | Organization |
| Organization Name | ST ELIZABETH SOUTHWOODS IMAGING LLC |
| Other Organization Name | SOUTHWOODS IMAGING CENTER |
| Practice Address |
250 Debartolo Pl Bldg B Youngstown OH 44512-7004 |
| Practice Telephone | 3307262595 |
| Practice Fax Number | 3307263249 |
| Mailing Telephone | 3307262595 |
| Mailing Fax Number | 3307263249 |
| Enumeration Date | 2008-02-06 |
| Last Update Date | 2008-02-06 |
| Authorized Official Name | MR. JAMES E FULCINITI (TREASURER) |
| Authorized Official Telephone | 3307290357 |
| Authorized Official Credential | CPA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0200X |
Clinic/Center Specialization: Radiology |
0056IC | OH | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Southwoods Imaging Center | Doing Business As Name - Organization |
| Street Address |
250 DEBARTOLO PL BLDG B |
| City | YOUNGSTOWN |
| State | OH |
| Zip Code | 44512-7004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891794129 | Asad Azarvan | Radiology | 250 Debartolo Pl, Youngstown, OH 44512-7004 | 2005-07-19 |
| 1578193967 | Alexandra Kristine Shivers | Nurse Practitioner | 250 Debartolo Pl, Youngstown, OH 44512-7004 | 2020-01-24 |
| 1841780467 | Maria Ann Hendrix | Nurse Practitioner | 250 Debartolo Pl, Youngstown, OH 44512-7004 | 2018-05-18 |
| 1144341462 | David J. Dunch, M. D., Inc. | Colon & Rectal Surgery | 250 Debartolo Pl, Suite 1640, Youngstown, OH 44512-7004 | 2007-04-03 |
| 1154357754 | The Heart Center of Northeastern Ohio Inc | Internal Medicine | 250 Debartolo Pl, Suite 2750, Youngstown, OH 44512-7004 | 2006-06-24 |
| 1467491845 | Southwood Pet Scan, LLC | Radiology | 250 Debartolo Pl, Building B, Youngstown, OH 44512-7004 | 2006-06-04 |
| 1457339376 | David J Dunch | Colon & Rectal Surgery | 250 Debartolo Pl, Suite 1640, Youngstown, OH 44512-7004 | 2006-01-03 |
| 1215919071 | Richard Thomas Esper | Internal Medicine | 250 Debartolo Pl, Suite 2750, Youngstown, OH 44512-7004 | 2005-11-17 |
| 1003807025 | Jeffrey C Halley | Internal Medicine | 250 Debartolo Pl, Suite 2750, Youngstown, OH 44512-7004 | 2005-10-31 |
| 1114917432 | Keith H Kuppler | Internal Medicine | 250 Debartolo Pl, Suite 2750, Youngstown, OH 44512-7004 | 2005-10-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285248740 | Kimberly Vrabel | Counselor | 725 Boardman Canfield Road Road Unit 1 and Unit 2, Boardman, OH 44512 | 2020-09-02 |
| 1043830144 | Steffi Lorraine D'souza | Student in an Organized Health Care Education/Training Program | 8423 Market Street Suite 101 St. Elizabeth Boardman Hos, Boardman, OH 44512 | 2020-04-20 |
| 1427677830 | Shivani Sharma | Family Medicine | 8423 Market Street Suite 101, St Elizabeth Boardman Hospital, Boardman, OH 44512 | 2020-04-15 |
| 1417587825 | Ronny Zetts | Pharmacist | 308 Boardman-canfield Rd, Boardman, OH 44512 | 2020-01-24 |
| 1285105080 | Andrew Dawson | Nurse Practitioner | 883 Boardman Canfield Rd Ste 105, Youngstown, OH 44512 | 2018-12-06 |
| 1700374949 | Adam Leid | Student in an Organized Health Care Education/Training Program | St Elizabeth Boardman Hospital - Medical Education Dept, 8401 Market Street, Boardman, OH 44512 | 2018-04-24 |
| 1528574910 | Herman Frank IIi | Licensed Practical Nurse | 920 Boardman Canfield Road, Boardman, OH 44512 | 2017-12-20 |
| 1730601980 | Stephanie Ann Mathews | Nurse Practitioner | 7600 Southern Blvd #1, Boardman, OH 44512 | 2017-07-10 |
| 1417485079 | Telka Ghobadi | Family Medicine | 8423 Market St., Suite 101, Boardman, OH 44512 | 2017-05-26 |
| 1356797534 | Haroon Hussain Syed | Student in an Organized Health Care Education/Training Program | 8423 Market Street, St. Elizabeth Boardman Hospital, Boardman, OH 44512 | 2016-05-06 |
| Find all providers in zip 44512 | ||||
| Taxonomy Code | 261QR0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology |
| Definition to come... |
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|---|---|---|---|---|
| 1023466240 | Rpj Liberty Enterprises LLC | Clinic/Center | 4300 Belmont Ave, Suite #6, Youngstown, OH 44505-1084 | 2016-05-27 |
| 1326171364 | Mri Cooperative | Clinic/Center | 500 Gypsy Ln, Youngstown, OH 44504-1315 | 2007-03-13 |
| 1558494500 | Mri Cooperative | Clinic/Center | 20 Ohltown Rd, Youngstown, OH 44515-2331 | 2007-03-13 |
| 1659404416 | Mri Cooperative | Clinic/Center | 6505 Market St, Youngstown, OH 44512-3457 | 2007-03-13 |
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|---|---|---|---|---|
| 1073121521 | Executive Imaging, LLC | Clinic/Center | 1069 Delaware Ave Ste 104, Marion, OH 43302-6459 | 2020-07-21 |
| 1912532904 | Northern Ohio Medical Specialists, LLC | Clinic/Center | 26151 Euclid Ave Ste 130, Euclid, OH 44132-3300 | 2020-03-10 |
| 1326510868 | Genetesis, Inc. | Clinic/Center | 5412 Courseview Dr Ste 150, Mason, OH 45040-2483 | 2018-12-21 |
| 1225507551 | Imaging Support Services Inc | Clinic/Center | 4244 Aicholtz Road Suite D, Cincinnati, OH 45245 | 2018-11-15 |
| 1710417605 | B&d Radiology Partners Pllc | Clinic/Center | 452 Ashsteade Ln, Cincinnati, OH 45255-3710 | 2017-06-14 |
| 1235671710 | Citran Xray LLC | Clinic/Center | 7774 Dayton Springfield Road, Fairborn, OH 45324-1996 | 2016-11-15 |
| 1598163164 | Fostoria Hospital Association | Clinic/Center | 455 W 4th St Ste 30, Fostoria, OH 44830-1864 | 2014-12-15 |
| 1487991360 | Birchcrest Holdings, LLC | Clinic/Center | 19250 Bagley Rd Ste 202, Cleveland, OH 44130 | 2013-01-11 |
| 1487922548 | Northern Ohio Medical Specialists, LLC | Clinic/Center | 2800 Hayes Ave # Bdlgc130, Sandusky, OH 44870 | 2011-12-05 |
| 1164726360 | Birchcrest Holdings, LLC | Clinic/Center | 4760 Richmond Rd Ste 300, Cleveland, OH 44128 | 2011-01-03 |
| Find all providers with the same taxonomy | ||||
| City | YOUNGSTOWN |
| Zip Code | 44512 |
Please comment or provide details below to improve the information on ST ELIZABETH SOUTHWOODS IMAGING LLC.
| 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.