Healthcare Provider Details

I. General information

NPI: 1619199932
Provider Name (Legal Business Name): PRESGAR IMAGING OF AUGUSTA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 10/28/2021
Certification Date: 10/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3610 WHEELER ROAD
AUGUSTA GA
30909
US

IV. Provider business mailing address

23110 STATE RD 54 PMB 292
LUTZ FL
33549
US

V. Phone/Fax

Practice location:
  • Phone: 706-210-9500
  • Fax: 706-210-9600
Mailing address:
  • Phone: 352-578-2055
  • Fax: 813-977-0143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBBIE ROBERTSON
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 813-323-2594