STEEL VALLEY DIVERSIFIED, INC (STEEL VALLEY PORTABLE X-RAY) - NPI NUMBER 1508890591

Summary

Provider Name: STEEL VALLEY DIVERSIFIED, INC (STEEL VALLEY PORTABLE X-RAY)

NPI Number: 1508890591

Clasification: Clinic/Center (261QR0208X)

Specialization: Radiology, Mobile

Address:
5136 TUSCARAWAS ST W
CANTON, OH
ZIP 44708

Phone Number: (330) 479-1908



Detailed Information

STEEL VALLEY DIVERSIFIED, INC is a radiology, mobile clinic/center in Canton, OH. The assigned NPI number for this provider is 1508890591 and is registered as an organization entity type.
The provider Is Doing Business As Steel Valley Portable X-ray.

The provider's business address is:

5136 TUSCARAWAS ST W
CANTON, OH
ZIP 44708-016
Phone: (330) 479-1908
Fax: (330) 479-1933

The provider's authorized official is Terry Lynn Ray .
The authorized official title is President and has the following contact phone number (330) 479-1908.

The enumeration date for this NPI number is 7/10/2006 and was last updated on 7/8/2007.

Map - Location of Practice

Similar Providers

NPI Provider Name / Taxonomy
1013964923 RICHARD D WATKINS CANTON COMMUNITY CLINIC INC
Clinic/Center (Federally Qualified Health Center (FQHC))
1063736726 MICHAEL TIRMONIA, DO, INC
Clinic/Center (Primary Care)
1063838910 SARAH DAY CARE CENTERS INC
Clinic/Center (Adult Day Care)
1033477906 CRISIS INTERVENTION AND RECOVERY CENTER, INC.
Clinic/Center (Adult Mental Health)
1053437384 JOSEPHINE E. GLOVER, DBA
Clinic/Center (Mental Health (Including Community Mental Health Center))
1982916573 STEEL VALLEY DIVERSIFIED, INC
Clinic/Center (Radiology, Mobile)
1023362100 MERCY MEDICAL CENTER, INC.
Clinic/Center (Dental)

Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 261QR0208X Clinic/Center Radiology, Mobile Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 3698641 MEDICARE ID-TYPE UNSPECIFIED OH
2 2215490 MEDICAID OH

NPI Record

No. Field Name Field Value
1 NPI 1508890591
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name STEEL VALLEY DIVERSIFIED, INC
5 Provider Other Organization Name STEEL VALLEY PORTABLE X-RAY
6 Provider Other Organization Name Type Code 3
7 Provider First Line Business Practice Location Address 5136 TUSCARAWAS ST W
8 Provider Business Practice Location Address City Name CANTON
9 Provider Business Practice Location Address State Name OH
10 Provider Business Practice Location Address Postal Code 447085016
11 Provider Business Practice Location Address Country Code If outside U S US
12 Provider Business Practice Location Address Telephone Number 3304791908
13 Provider Business Practice Location Address Fax Number 3304791933
14 Provider Enumeration Date 7/10/2006
15 Last Update Date 7/8/2007
16 Authorized Official Last Name RAY
17 Authorized Official First Name TERRY
18 Authorized Official Middle Name LYNN
19 Authorized Official Title or Position PRESIDENT
20 Authorized Official Telephone Number 3304791908
21 Healthcare Provider Taxonomy Code 1 261QR0208X
22 Healthcare Provider Primary Taxonomy Switch 1 Y
23 Other Provider Identifier 1 3698641
24 Other Provider Identifier Type Code 1 04
25 Other Provider Identifier State 1 OH
26 Other Provider Identifier 2 2215490
27 Other Provider Identifier Type Code 2 05
28 Other Provider Identifier State 2 OH
29 Authorized Official Name Prefix Text MRS.

Download Record

Download this NPI record in Text format: Export

Download this NPI record in Excel (CSV) format: Export

Download this NPI record in XML format: Export




This page was last updated on: 8/12/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.