Healthcare Provider Details

I. General information

NPI: 1285619270
Provider Name (Legal Business Name): IMAGING ALLIANCE NASHVILLE PET LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 06/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 WHITE BRIDGE RD IMAGING ALLIANCE NASHVILLE PET LLC
NASHVILLE TN
37205
US

IV. Provider business mailing address

PO BOX 440070
NASHVILLE TN
37244-0070
US

V. Phone/Fax

Practice location:
  • Phone: 615-354-1255
  • Fax: 615-354-9806
Mailing address:
  • Phone: 615-312-0600
  • Fax: 615-320-3259

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: MR. WARREN ALEXANDER
Title or Position: COO
Credential:
Phone: 615-329-0570