Executive Image Inc

LBN: Executive Image Inc
Executive Image Inc is an health care organization with primary practice located at 7820 N Point Blvd Suite 101, Winston Salem NC 27106-3299. The organization recently has only one registered license in Suppliers / Portable X-ray and/or Other Portable Diagnostic Imaging Supplier, which is considered as the primary health care specialty. Executive Image Inc can be contacted via phone (336) 245-0647, or through Goolsby, Diana via phone (336) 918-6328.

Contact Information

Primary practice address
7820 N Point Blvd Suite 101 Winston Salem NC 27106-3299
Fax: (336) 245-0649
Website:
Authorized official contact:
Name: Goolsby, Diana

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Portable X-ray and/or Other Portable Diagnostic Imaging Supplier 335V00000X 600495328 North Carolina

Profile Details

NPI number 1588759849
LBN Legal business name Executive Image Inc
DBA Doing business as
Authorized official Goolsby, Diana
Entity Organization
Organization subpart 1 No
Enumeration date Oct 4th, 2006
Last updated Jan 15th, 2015 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588759849 NPPES
North Carolina Other P00245445 MEDICARE RAILROAD
North Carolina MEDICAID 3409805 MEDICARE RAILROAD

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