Novant Health Imaging Southpark
LBN: Mecklenburg Diagnostic Imaging Llc
Novant Health Imaging Southpark is an health care organization with primary practice located at 6324 Fairview Rd Suite 120 A, Charlotte NC 28210-3200. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as the primary health care specialty.
Mecklenburg Diagnostic Imaging Llc can be contacted via phone (704) 362-8444, or through Gardner, Geoffrey K. via phone (336) 718-2078.
Contact Information
Primary practice address
6324 Fairview Rd Suite 120 A
Charlotte NC 28210-3200
Phone: (704) 362-8444
Fax: (704) 362-3557
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | North Carolina |
Profile Details
| NPI number | 1093773384 |
|---|---|
| LBN Legal business name | Mecklenburg Diagnostic Imaging Llc |
| DBA Doing business as | Novant Health Imaging Southpark |
| Authorized official | Gardner, Geoffrey K. |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | May 3rd, 2006 |
| Last updated | Mar 19th, 2024 - about 8 months 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093773384 | NPPES |
| South Carolina | MEDICAID | SL0083 | |
| South Carolina | Other | 01514 | |
| South Carolina | MEDICAID | NPB300 | |
| South Carolina | Other | 153718700 | |
| South Carolina | Other | P00315955 | |
| South Carolina | MEDICAID | 6901514 |
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