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General NPI Number Information
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NPI Number | 1164670667
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Entity Type | Organization
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Legal Business Name | HOME CARE IMAGING
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Dates
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Enumeration Date | 09/09/2008
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Last Update Date | 09/09/2008
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Provider Practice Location Address
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Address Line | 187 SHERWOOD FOREST DR
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City | DOUGLASVILLE
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State | GA
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Zip | 30134-5808
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Country | US
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Telephone | 678-668-3101
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Fax | 404-696-1997
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Provider Business Mailing Address
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Address Line | 187 SHERWOOD FOREST DR
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City | DOUGLASVILLE
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State | GA
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Zip | 30134-5808
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Country | US
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Telephone | 678-668-3101
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Fax | 404-696-1997
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Authorized Official
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Title or Position | CEO
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Name | AMIRA KARRIEM
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Credential | RT(R)(M) ARRT
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Telephone | 678-668-3101
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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 | 326204
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License Number State | GA
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