OLD TRAIL IMAGING, LLC (NPI# 1558303016) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558303016 |
| Entity Type | Organization |
| Organization Name | OLD TRAIL IMAGING, LLC |
| Practice Address |
21 Susquehanna Valley Mall Drive Selinsgrove PA 17870-8409 |
| Practice Telephone | 5703744411 |
| Mailing Telephone | 5703744411 |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | LINDA THOMS (OPERATIONS MANAGER) |
| Authorized Official Telephone | 5703744411 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 207RM1200X |
Internal Medicine Specialization: Magnetic Resonance Imaging (MRI) |
Allopathic & Osteopathic Physicians | ||
| X | 2085B0100X |
Radiology Specialization: Body Imaging |
Allopathic & Osteopathic Physicians | ||
| X | 2085U0001X |
Radiology Specialization: Diagnostic Ultrasound |
Allopathic & Osteopathic Physicians |
| Street Address |
21 SUSQUEHANNA VALLEY MALL DRIVE |
| City | SELINSGROVE |
| State | PA |
| Zip Code | 17870-8409 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295956498 | Sun Orthopaedic Group | Durable Medical Equipment & Medical Supplies | 21 Susquehanna Valley Mall Drive, Selinsgrove, PA 17801 | 2007-05-02 |
| 1821122128 | Dca of Selinsgrove LLC | Clinic/Center | 21 Susquehanna Valley Mall Drive, Selinsgrove, PA 17870-9147 | 2007-03-16 |
| 1023110459 | Divine Providence Hospital of The Sisters of Christian Charity | Clinic/Center | 21 Susquehanna Valley Mall Drive, Suite D, Selinsgrove, PA 17870 | 2006-09-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518423565 | Mark Douglas Sanders | Optometrist | 217 Sweet Gum Road, Selinsgrove, PA 17870 | 2019-02-14 |
| 1700298767 | Jagdeep Goraya | Dentist | 2192 N Susquehanna Trail, Selinsgrove, PA 17870 | 2014-05-27 |
| 1750680880 | Bayada Home Health Care, Inc. | Home Health | 8 West Snyder Street, Selinsgrove, PA 17870 | 2011-03-15 |
| 1275850620 | Geisinger Medical Center | General Acute Care Hospital | 620 University Avenue, Selinsgrove, PA 17870 | 2010-04-26 |
| 1023253275 | Gregory Reese D.c | Chiropractor | 1372 N. Susq. Trl. Ste. 120, Selinsgrove, PA 17870 | 2008-12-02 |
| 1639349897 | Semian Surgical Associates LLC | Clinic/Center | One Commerce Avenue, Selinsgrove, PA 17870 | 2008-03-04 |
| 1225250376 | Grayson Selinsgrove Limited Partnership | Assisted Living Facility | 29 Grayson View Court, Selinsgrove, PA 17870 | 2007-05-02 |
| 1225166234 | Darla R. Miller, Dpm | Podiatrist | 1018 N Susquehanna Trail, Selinsgrove, PA 17870 | 2007-03-01 |
| 1578627626 | Susquehanna Valley Foot and Ankle Center, Inc | Podiatrist | 1018 North Susquehanna Trail, Selinsgrove, PA 17870 | 2006-12-21 |
| 1447319355 | Vision Max | Optometrist | 1026 N Susquehanna Trail, Selinsgrove, PA 17870 | 2006-12-06 |
| Find all providers in zip 17870 | ||||
| Taxonomy Code | 207RM1200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Magnetic Resonance Imaging (MRI) |
| Definition to come. |
| City | SELINSGROVE |
| Zip Code | 17870 |
Please comment or provide details below to improve the information on OLD TRAIL IMAGING, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.