Provider Demographics
NPI:1104919000
Name:CONSULTING RADIOLOGISTS CORPORATION
Entity type:Organization
Organization Name:CONSULTING RADIOLOGISTS CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLER
Authorized Official - Prefix:
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:MUNGUIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-254-2115
Mailing Address - Street 1:2658 W LASKEY RD
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43613-3288
Mailing Address - Country:US
Mailing Address - Phone:419-473-8100
Mailing Address - Fax:419-473-8109
Practice Address - Street 1:2658 W LASKEY RD
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43613-3288
Practice Address - Country:US
Practice Address - Phone:419-473-8100
Practice Address - Fax:419-473-8109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1939853Medicaid
OHCM1619OtherRAILROAD MEDICARE
OHCM1619OtherRAILROAD MEDICARE