Healthcare Provider Details

I. General information

NPI: 1134589716
Provider Name (Legal Business Name): HIGH DESERT IMAGING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2016
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2110 IDAHO ST
ELKO NV
89801-2625
US

IV. Provider business mailing address

PO BOX 1625
EVANSVILLE IN
47706-0027
US

V. Phone/Fax

Practice location:
  • Phone: 775-621-5800
  • Fax:
Mailing address:
  • Phone: 775-621-5800
  • Fax: 775-621-5801

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: RYAN REDELMAN
Title or Position: PRESIDENT, OWNER
Credential: MD
Phone: 775-445-5500