Provider Demographics
NPI:1568634582
Name:ECG SCANNING & MEDICAL SERVICES, INC
Entity type:Organization
Organization Name:ECG SCANNING & MEDICAL SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:NASUTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-346-5837
Mailing Address - Street 1:3055 KETTERING BLVD STE 219-A
Mailing Address - Street 2:
Mailing Address - City:MORAINE
Mailing Address - State:OH
Mailing Address - Zip Code:45439-1989
Mailing Address - Country:US
Mailing Address - Phone:800-346-5837
Mailing Address - Fax:937-395-4415
Practice Address - Street 1:3055 KETTERING BLVD STE 219-A
Practice Address - Street 2:
Practice Address - City:MORAINE
Practice Address - State:OH
Practice Address - Zip Code:45439-1989
Practice Address - Country:US
Practice Address - Phone:800-346-5837
Practice Address - Fax:937-395-4415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-31
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000014957OtherANTHEM BCBS
OHECID00281Medicare PIN
OH000000014957OtherANTHEM BCBS