Southtowne Imaging Center Llc

LBN: Southtowne Imaging Center Llc
Southtowne Imaging Center Llc is an health care organization with primary practice located at 20 Southtowne Dr , Potosi MO 63664-5729. The organization recently has only one registered license in Ambulatory Health Care Facilities / Radiology, which is considered as the primary health care specialty. Southtowne Imaging Center Llc can be contacted via phone (573) 436-6736, or through Boots, Henry via phone (573) 315-9109.

Contact Information

Primary practice address
20 Southtowne Dr Potosi MO 63664-5729
Phone: (573) 436-6736
Fax: (573) 436-7321
Website:
Map and Directions
Authorized official contact:
Name: Boots, Henry
Phone: (573) 315-9109

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Radiology 261QR0200X

Profile Details

NPI number 1104991918
LBN Legal business name Southtowne Imaging Center Llc
DBA Doing business as
Authorized official Boots, Henry
Entity Organization
Organization subpart 1 No
Enumeration date Nov 21st, 2006
Last updated Feb 17th, 2015 - about 9 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 1104991918 NPPES
Missouri Other 269801 GHP NUMBER
Missouri MEDICAID 710002502 GHP NUMBER
Missouri Other P00277531 GHP NUMBER
Missouri Other 59787 GHP NUMBER

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