Provider Demographics
NPI:1285317412
Name:CHOICEONE DIAGNOSTICS, LLC
Entity type:Organization
Organization Name:CHOICEONE DIAGNOSTICS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:RUGGLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-379-4360
Mailing Address - Street 1:2081 HARRODSBURG RD # 1046
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-3503
Mailing Address - Country:US
Mailing Address - Phone:859-379-4360
Mailing Address - Fax:
Practice Address - Street 1:285 MOCKS CREEK DR
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40422-9255
Practice Address - Country:US
Practice Address - Phone:859-583-3212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-14
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology