Healthcare Provider Details

I. General information

NPI: 1396062360
Provider Name (Legal Business Name): JATS IMAGING SERVICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2010
Last Update Date: 04/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1962 JULIA ST
RAYVILLE LA
71269-5527
US

IV. Provider business mailing address

1101 JULIA ST
RAYVILLE LA
71269-2962
US

V. Phone/Fax

Practice location:
  • Phone: 318-728-8839
  • Fax: 318-728-8940
Mailing address:
  • Phone: 318-728-4553
  • Fax:

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: MR. JOSEPH FRANCIS SYLVESTRI
Title or Position: OWNER
Credential:
Phone: 318-728-4553