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Penrad Imaging LLC

Clinic/Center, Radiology in Colorado Springs, CO. Organization (NPI-2).

NPI number1851992291
StatusActive
Last updated in NPPESNov 3, 2020

Details

NPI
1851992291
Entity type
Organization (NPI-2)
Legal business name
Penrad Imaging LLC
Organization subpart
No
Enumeration date
Nov 3, 2020
Certification date
Nov 3, 2020
Last updated
Nov 3, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QR0200X Clinic/Center, Radiology––Yes

Practice location

4105 Briargate Pkwy Ste 115
Colorado Springs, CO 80920-3482

Phone 719-593-1799 · Fax 719-265-3794

Mailing address

Po Box 2989
Colorado Springs, CO 80901-2989

Phone 719-593-1799 · Fax 719-265-3794

Authorized official

Derek Scott Bergeson
Radiologist
7195931799

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