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General NPI Number Information
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NPI Number | 1003110271
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Entity Type | Organization
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Legal Business Name | PRI X-RAY, LLC
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Dates
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Enumeration Date | 01/03/2011
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Last Update Date | 01/03/2011
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Provider Practice Location Address
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Address Line | 4040 MOUNTAIN CREEK RD APARTMENT 1304
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City | CHATTANOOGA
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State | TN
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Zip | 37415-6034
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Country | US
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Telephone | 770-932-8599
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Fax | 770-614-8048
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Provider Business Mailing Address
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Address Line | 4040 MOUNTAIN CREEK RD
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City | CHATTANOOGA
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State | TN
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Zip | 37415-6034
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Country | US
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Telephone | 770-932-8599
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Fax | 770-614-8048
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. WILLIAM LANGSTON
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Credential |
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Telephone | 770-932-8599
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335V00000X
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Taxonomy Name | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
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License Number |
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License Number State |
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