1285066118 NPI number — MEDICAL IMAGING, INC.

Table of content: (NPI 1285066118)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285066118 NPI number — MEDICAL IMAGING, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEDICAL IMAGING, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
QUANTUM CT
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285066118
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/02/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6002 DIAMOND RUBY STE 3
Provider Second Line Business Mailing Address:
PMB 354
Provider Business Mailing Address City Name:
CHRISTIANSTED
Provider Business Mailing Address State Name:
VI
Provider Business Mailing Address Postal Code:
00820-5226
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
340-692-2882
Provider Business Mailing Address Fax Number:
340-692-2883

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4500 SUNNY ISLE SHOPPING CENTER
Provider Second Line Business Practice Location Address:
STE B3
Provider Business Practice Location Address City Name:
CHRISTIANSTED
Provider Business Practice Location Address State Name:
VI
Provider Business Practice Location Address Postal Code:
00820-4492
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
340-692-2882
Provider Business Practice Location Address Fax Number:
340-692-2883
Provider Enumeration Date:
08/02/2013

Additional Information

Authorized Official

Authorized Official Last Name:
GALIBER
Authorized Official First Name:
MARCEL
Authorized Official Middle Name:
LOUIS
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
340-692-2882

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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