Provider Demographics
NPI:1306886643
Name:VIRGINIA HIGHLANDS RADIOLOGY, P. C.
Entity type:Organization
Organization Name:VIRGINIA HIGHLANDS RADIOLOGY, P. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:C
Authorized Official - Last Name:BANNING
Authorized Official - Suffix:JR
Authorized Official - Credentials:M D
Authorized Official - Phone:540-862-6287
Mailing Address - Street 1:PO BOX 11643
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24022-1643
Mailing Address - Country:US
Mailing Address - Phone:540-835-6287
Mailing Address - Fax:540-862-6585
Practice Address - Street 1:1 ARH LN
Practice Address - Street 2:
Practice Address - City:LOW MOOR
Practice Address - State:VA
Practice Address - Zip Code:24457
Practice Address - Country:US
Practice Address - Phone:540-862-6287
Practice Address - Fax:540-862-6585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC05005Medicare ID - Type Unspecified