Provider Demographics
NPI:1336987965
Name:ADVANCED DIAGNOSTIC IMAGING PC
Entity type:Organization
Organization Name:ADVANCED DIAGNOSTIC IMAGING PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:LOGAN
Authorized Official - Last Name:CALENDINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-239-2018
Mailing Address - Street 1:3024 BUSINESS PARK CIR
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-3132
Mailing Address - Country:US
Mailing Address - Phone:615-239-2018
Mailing Address - Fax:615-851-2018
Practice Address - Street 1:1909 MALLORY LN STE 201
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-2842
Practice Address - Country:US
Practice Address - Phone:615-814-0885
Practice Address - Fax:615-814-0056
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVANCED DIAGNOSTIC IMAGING PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment