ELITE IMAGING OF NORTH COUNTY, LLC


Address: 433 Lynn Haven Ln, Hazelwood, MO 63042-1808
Phone: 3147310600

ELITE IMAGING OF NORTH COUNTY, LLC (NPI# 1720232192) 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) 1720232192
Entity Type Organization
Organization Name ELITE IMAGING OF NORTH COUNTY, LLC
Practice Address 433 Lynn Haven Ln
Hazelwood
MO 63042-1808
Practice Telephone 3147310600
Practice Fax Number 3147310601
Mailing Telephone 3147310600
Mailing Fax Number 3147310601
Enumeration Date 2008-11-11
Last Update Date 2008-12-16
Authorized Official Name CECIL S. GRAY (MEMBER)
Authorized Official Telephone 9136696161
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QR0200X Clinic/Center
Specialization: Radiology
Ambulatory Health Care Facilities

Office Location

Street Address 433 LYNN HAVEN LN
City HAZELWOOD
State MO
Zip Code 63042-1808

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Taxonomy Information

Taxonomy Code 261QR0200X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Radiology

Taxonomy Definition

Definition to come...

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1437476900 Pearl Imaging, LLC Clinic/Center 4293 Veterans Memorial Pkwy, Saint Peters, MO 63376-1657 2010-04-23
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Competitor

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City HAZELWOOD
Zip Code 63042

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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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