Healthcare Provider Details

I. General information

NPI: 1548058605
Provider Name (Legal Business Name): MOBILE IMAGING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2025
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 5TH ST STE 117
MERIDIAN MS
39301-5845
US

IV. Provider business mailing address

2211 5TH ST STE 117
MERIDIAN MS
39301-5845
US

V. Phone/Fax

Practice location:
  • Phone: 601-621-4522
  • Fax: 601-621-4615
Mailing address:
  • Phone: 601-621-4522
  • Fax: 601-621-4615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: CHARLES MATTHEW HANEY
Title or Position: OWNER
Credential:
Phone: 601-621-4522