Healthcare Provider Details
I. General information
NPI: 1437108842
Provider Name (Legal Business Name): BIOTECH X-RAY INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/10/2006
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1065 EXECUTIVE PARKWAY DR STE 220
SAINT LOUIS MO
63141-6367
US
IV. Provider business mailing address
1065 EXECUTIVE PARKWAY DR STE 220
SAINT LOUIS MO
63141-6367
US
V. Phone/Fax
- Phone: 314-227-2700
- Fax: 314-227-2720
- Phone: 314-227-2700
- Fax: 314-227-2720
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 293D00000X |
| Taxonomy | Physiological Laboratory |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 335V00000X |
| Taxonomy | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TAMARA
BISHOP
SCHWARTZ
Title or Position: PRESIDENT
Credential:
Phone: 314-440-1770