LAKE HAVASU IMAGING CENTER INC (NPI# 1710919261) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710919261 |
| Entity Type | Organization |
| Organization Name | LAKE HAVASU IMAGING CENTER INC |
| Practice Address |
1944 Mesquite Ave Lake Havasu City AZ 86403 |
| Mailing Address |
1944 Mesquite Ave Lake Havasu City AZ 86403-5729 |
| Practice Telephone | 9285059729 |
| Practice Fax Number | 9285059200 |
| Mailing Telephone | 9285059729 |
| Mailing Fax Number | 9285059200 |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2019-12-10 |
| Authorized Official Name | SYLVIA HEINER (OFFICE MANAGER) |
| Authorized Official Telephone | 9285059729 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
Allopathic & Osteopathic Physicians | ||
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | RAIL ROAD MEDICARE | 470000882 | 01 |
| AZ | 583729 | 05 |
| Street Address |
1944 MESQUITE AVE |
| City | LAKE HAVASU CITY |
| State | AZ |
| Zip Code | 86403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528003233 | Radiological Services of Northern Arizona, PC | Radiology | 1944 Mesquite Ave, Lake Havasu City, AZ 86403-5729 | 2006-06-17 |
| 1609808153 | Ayman Nicholas Awad | Radiology | 1944 Mesquite Ave, Lake Havasu City, AZ 86403-5729 | 2006-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104479039 | Liska's Apothecary Shop, Inc. | Assisted Living Facility | 1840 Mesquite Ave., Ste. E, Lake Havasu City, AZ 86403 | 2019-07-19 |
| 1275033227 | Ayad Costy | Pharmacist | 75 North Lake Havasu City, Lake Havasu City, AZ 86403 | 2018-02-16 |
| 1942727250 | Ideal Health Care, L.L.C. | Prosthetic/Orthotic Supplier | 1675 Mesquite Ave Ste A, Lake Havasu City, AZ 86403 | 2017-08-28 |
| 1063965036 | Cerner Health Connections, Inc | Clinic/Center | 89 Civic Center Blvd, Lake Havasu City, AZ 86403 | 2016-07-26 |
| 1447643358 | Lundin Dental PC | Durable Medical Equipment & Medical Supplies | 1741 Mesquite Avenue Ste B 100, Lake Havasu City, AZ 86403 | 2015-03-17 |
| 1912301425 | Arizona Havasu Bdm Pak LLC | Dentist | 1799 North Kiowa Blvd, Unit 109, Lake Havasu, AZ 86403 | 2014-10-13 |
| 1386047850 | Emily E Vona | Nurse Practitioner | 84 Acoma Blvd N Ste 104, Lake Havasu City, AZ 86403 | 2014-09-29 |
| 1750700589 | Thomas Wennergren | Pharmacist | 25 S Lake Havasu Ave, Lake Havasu City, AZ 86403 | 2014-04-09 |
| 1285997460 | Jamie L Lemire | Pharmacist | 1980 Mcculloch Blvd, Lake Havasu City, AZ 86403 | 2012-06-21 |
| 1053694448 | Goodwill of Northern Arizona | Exclusive Provider Organization | 1990 Mcculloch Blvd North, Lake Havasu City, AZ 86403 | 2011-09-22 |
| Find all providers in zip 86403 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972825644 | Havasu Regional Medical Center LLC | Radiology | 1799 Kiowa Ave, # 104, Lake Havasu City, AZ 86403-2881 | 2010-02-23 |
| 1972657633 | Daniel Rawn Emig | Radiology | 3662 N Winifred Way, Lake Havasu City, AZ 86404-5959 | 2007-01-22 |
| 1528003233 | Radiological Services of Northern Arizona, PC | Radiology | 1944 Mesquite Ave, Lake Havasu City, AZ 86403-5729 | 2006-06-17 |
| 1598750820 | Jack D Dunn | Radiology | 2130 Mesquite Ave Unit 108, Lake Havasu City, AZ 86403-6897 | 2005-09-13 |
| 1497264873 | Pinnacle Radiology Services | Radiology | 101 Civic Center Ln, Lake Havasu City, AZ 86403-5607 | 2017-09-28 |
| 1316275290 | Peter M. Mamalakis | Radiology | 101 Civic Center Ln, Lake Havasu City, AZ 86403-5607 | 2009-12-03 |
| 1104064997 | Arizona Coast Radiology, Pllc | Radiology | 101 Civic Center Ln, Lake Havasu City, AZ 86403-5607 | 2009-02-02 |
| 1952592339 | Lake Havasu Radiology, Pllc | Radiology | 101 Civic Center Ln, Lake Havasu City, AZ 86403-5607 | 2007-08-09 |
| 1609808153 | Ayman Nicholas Awad | Radiology | 1944 Mesquite Ave, Lake Havasu City, AZ 86403-5729 | 2006-07-07 |
| 1669438867 | Open Mri of Lake Havasu LLC | Radiology | 2082 Mesquite Ave, Suite 114, Lake Havasu City, AZ 86403-6717 | 2006-04-25 |
| Find all providers in LAKE HAVASU CITY | ||||
| City | LAKE HAVASU CITY |
| Zip Code | 86403 |
Please comment or provide details below to improve the information on LAKE HAVASU IMAGING CENTER INC.
| 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.