Healthcare Provider Details
I. General information
NPI: 1295791325
Provider Name (Legal Business Name): ADVANCED IMAGING PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/26/2006
Last Update Date: 05/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
508 CLEVELAND ST
GREAT BEND KS
67530-3562
US
IV. Provider business mailing address
508 CLEVELAND ST
GREAT BEND KS
67530-3562
US
V. Phone/Fax
- Phone: 620-792-7300
- Fax: 620-792-7320
- Phone: 620-792-7300
- Fax: 620-792-7320
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM1200X |
| Taxonomy | Magnetic Resonance Imaging (MRI) Clinic/Center |
| License Number | |
| License Number State | KS |
VIII. Authorized Official
Name: MRS.
PAMELA
KAY
CHAMBERS
Title or Position: ADMINISTRATOR
Credential:
Phone: 620-792-7300