Healthcare Provider Details

I. General information

NPI: 1619368529
Provider Name (Legal Business Name): MISSION IMAGING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2015
Last Update Date: 02/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

534 BILTMORE AVE SUITE 102
ASHEVILLE NC
28801-4612
US

IV. Provider business mailing address

PO BOX 602994
CHARLOTTE NC
28260-2994
US

V. Phone/Fax

Practice location:
  • Phone: 828-213-0801
  • Fax: 828-213-1133
Mailing address:
  • Phone: 828-213-1500
  • Fax: 828-651-6570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State

VIII. Authorized Official

Name: CHARLES FRANKLIN AYSCUE
Title or Position: CFO
Credential:
Phone: 828-213-1137