Provider Demographics
NPI:1366227951
Name:LOVE AT FIRST SCAN LLC
Entity type:Organization
Organization Name:LOVE AT FIRST SCAN LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:P
Authorized Official - Last Name:GRIMLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-508-9883
Mailing Address - Street 1:533 CHARLES CT
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-7865
Mailing Address - Country:US
Mailing Address - Phone:219-508-9883
Mailing Address - Fax:219-333-2123
Practice Address - Street 1:800 W BURRELL DR
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-8898
Practice Address - Country:US
Practice Address - Phone:219-310-8828
Practice Address - Fax:219-333-2123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-30
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile