Healthcare Provider Details

I. General information

NPI: 1245780873
Provider Name (Legal Business Name): VALLEY IMAGING NETWORK, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2016
Last Update Date: 10/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

626 S 3RD ST
LAS VEGAS NV
89101-6602
US

IV. Provider business mailing address

626 S 3RD ST
LAS VEGAS NV
89101-6602
US

V. Phone/Fax

Practice location:
  • Phone: 702-332-1452
  • Fax: 888-796-0769
Mailing address:
  • Phone: 702-332-1452
  • Fax: 888-796-0769

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247100000X
TaxonomyRadiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name: AVETIK HARUTUNIAN
Title or Position: CEO
Credential:
Phone: 702-332-1452