MOBILE MEDICAL IMAGING OF COASTAL GEORGIA, LLC (NPI# 1053858761) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1053858761 |
Entity Type | Organization |
Organization Name | MOBILE MEDICAL IMAGING OF COASTAL GEORGIA, LLC |
Practice Address |
5906 Hwy 21 S Unit 4 Springfield GA 31326-5505 |
Mailing Address |
5906 Hwy 21 S Unit 4 Rincon GA 31326-5505 |
Practice Telephone | 9122955611 |
Practice Fax Number | 8448956771 |
Mailing Telephone | 9122955611 |
Mailing Fax Number | 8448956771 |
Enumeration Date | 2017-01-20 |
Last Update Date | 2017-04-29 |
Authorized Official Name | JAMIE L HUBBARD (OWNER) |
Authorized Official Telephone | 9122955611 |
Authorized Official Credential | RT(R) ARRT |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | Suppliers |
Street Address |
5906 HWY 21 S UNIT 4 |
City | SPRINGFIELD |
State | GA |
Zip Code | 31326-5505 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437657160 | Vitality Counseling, Inc | Counselor | 135 Goshen Road Ext Ste 203, Rincon, GA 31326 | 2018-01-29 |
1174045322 | Katelyn Dodsworth Sundin | Dentist | 5871 Ga-21 S, Rincon, GA 31326 | 2017-07-10 |
1861943284 | Covenant Care, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 112 Goshen Commercial Park Dr., Rincon, GA 31326 | 2016-10-20 |
1013465681 | Aaron D. Webb | Nurse Practitioner | 423 S Columbia Avenue, Rincon, GA 31326 | 2016-09-13 |
1659726255 | Reagan Reese Powell | Counselor | 135 Goshen Rd Ext, Suite 203a, Rincon, GA 31326 | 2016-05-02 |
1982065652 | Shronda Bowman | Specialist | 1214n Columbia Ave, Unit B, Rincon, GA 31326 | 2016-03-09 |
1306202890 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 461 S Columbia Ave, Rincon, GA 31326 | 2016-01-13 |
1053628255 | Jennifer Erin Creech | Dentist | 429 S Columbia Ave, Rincon, GA 31326 | 2010-09-09 |
1548596737 | Rincon Medical Center | Clinic/Center | 119 Chimney Road, Rincon, GA 31326 | 2009-10-23 |
1770732968 | Hospital Authority of Effingham County | Clinic/Center | 110 Goshen Road, Rincon, GA 31326 | 2008-09-12 |
Find all providers in zip 31326 |
Taxonomy Code | 335V00000X |
Grouping | Suppliers |
Classification | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier |
A supplier that provides one or more of the following portable services, including but not limited to, x-ray, electrocardiogram (EKG), long-term EKG (Holter Monitor), bone densitometry, sonography, and other imaging services in accordance with all state and federal requirements, under the general supervision of a qualified physician. All necessary resources are transported to the patient's location where the services are performed. |
Notes: Source: National Uniform Claim Committee, 2015 [1/1/2016: title and definition modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427056522 | Kosma Mobile X-ray Co., Inc. | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 1678 S Farm Road 133, Springfield, MO 65807-1013 | 2005-07-12 |
1669613451 | Tri-lakes Mobile Ultrasound Inc. | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 5273 S Aaron Ave, Springfield, MO 65810-2879 | 2009-03-09 |
1851552905 | Radiology & Imaging, Inc. | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 1350 Main St, Suite 1007, Springfield, MA 01103-1664 | 2008-06-21 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982185237 | Guillaume J Pinguet | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 4760 Austell Rd Ste A, Austell, GA 30106-2007 | 2018-08-24 |
1790288587 | Acc3 International, Inc. | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 3340 Peachtree Rd Ne Ste 2025, Atlanta, GA 30326-1084 | 2018-03-17 |
1013392315 | Schryver Medical Sales and Marketing, LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 3500 Lenox Rd Ne, Suite 1500, Atlanta, GA 30326-4228 | 2015-07-28 |
1144609876 | Optimus Diagnostics LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 252 Holt Ave, Macon, GA 31201-1227 | 2015-05-27 |
1215316435 | Jlm X-ray LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 1015 Canton Street, Roswell, GA 30075 | 2015-05-20 |
1023410842 | The Pink Ribbon Mammography and Diagnostic Radiology Services LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 33 Darbys Ave, Hiram, GA 30141-4143 | 2014-09-24 |
1477826493 | Mobile Physician Services, LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 1171 Laurel Pointe, Bogart, GA 30622-2859 | 2012-02-22 |
1306140215 | Avery Partners, LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 1455 Old Alabama Rd Ste 160, Roswell, GA 30076-2167 | 2011-01-06 |
1700190105 | Source Diagnostics of Georgia, LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 5559 Thomaston Rd, Macon, GA 31220-8120 | 2010-07-28 |
1164670667 | Home Care Imaging | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 187 Sherwood Forest Dr, Douglasville, GA 30134-5808 | 2008-09-09 |
Find all providers with the same taxonomy |
City | SPRINGFIELD |
Zip Code | 31326 |
Please comment or provide details below to improve the information on MOBILE MEDICAL IMAGING OF COASTAL GEORGIA, 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.