Healthcare Provider Details

I. General information

NPI: 1346831625
Provider Name (Legal Business Name): BUCHMANN BIOMEDICAL IMAGING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2021
Last Update Date: 02/19/2021
Certification Date: 02/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3450 BRIDGELAND DR STE F
BRIDGETON MO
63044-2605
US

IV. Provider business mailing address

10626 DEERPATH ACRES CT
SAINT LOUIS MO
63128-2526
US

V. Phone/Fax

Practice location:
  • Phone: 314-972-0100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335V00000X
TaxonomyPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
License Number
License Number State

VIII. Authorized Official

Name: DR. NEESHA BUCHMANN
Title or Position: MANAGER
Credential: DO
Phone: 608-769-2704