Healthcare Provider Details

I. General information

NPI: 1952372930
Provider Name (Legal Business Name): MEDITEK/GREYSTONE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 10/28/2020
Certification Date: 10/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7500 HUGH DANIEL DR SUITE 150
BIRMINGHAM AL
35242-7148
US

IV. Provider business mailing address

PO BOX 931080
ATLANTA GA
31193-1080
US

V. Phone/Fax

Practice location:
  • Phone: 205-995-4900
  • Fax: 205-995-0203
Mailing address:
  • Phone: 205-995-9899
  • Fax: 205-995-1255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TRACI BROWN
Title or Position: DIRECTOR OF BILLING
Credential:
Phone: 706-256-3450