MOBILE MEDICAL IMAGING OF COASTAL GEORGIA, LLC


Address: 5906 Hwy 21 S, Unit 4, Springfield, GA 31326-5505
Phone: 9122955611

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 335V00000X Portable X-ray and/or Other Portable Diagnostic Imaging Supplier Suppliers

Office Location

Street Address 5906 HWY 21 S
UNIT 4
City SPRINGFIELD
State GA
Zip Code 31326-5505

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NPI Name Taxonomy Address Enumeration
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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
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Taxonomy Information

Taxonomy Code 335V00000X
Grouping Suppliers
Classification Portable X-ray and/or Other Portable Diagnostic Imaging Supplier

Taxonomy Definition

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]

Providers in the same taxonomy and city

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

Providers in the same taxonomy and state

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
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Competitor

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City SPRINGFIELD
Zip Code 31326

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Dataset Information

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.

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