Healthcare Provider Details

I. General information

NPI: 1154691715
Provider Name (Legal Business Name): JHL IMAGING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2012
Last Update Date: 05/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1836 BALLYBUNION DR
JOHNS CREEK GA
30097-2081
US

IV. Provider business mailing address

PO BOX 941551
MIAMI FL
33194-1551
US

V. Phone/Fax

Practice location:
  • Phone: 678-243-0581
  • Fax:
Mailing address:
  • Phone: 678-243-0581
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247100000X
TaxonomyRadiologic Technologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID LAWSON
Title or Position: OPERATIONS
Credential:
Phone: 678-243-0581