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NPI 1457741852

NPI 1457741852 : ST. CHRISTOPHER'S IMAGING, LLC : SHREVEPORT, LA

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General NPI Number Information
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    NPI Number           |    1457741852
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    Entity Type          |    Organization 
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    Legal Business Name  |    ST. CHRISTOPHER'S IMAGING, LLC 
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Dates
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    Enumeration Date     |    01/23/2015
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    Last Update Date     |    06/15/2015
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Provider Practice Location Address
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    Address Line         |    1725 ELIZABETH AVE 
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    City                 |    SHREVEPORT
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    State                |    LA
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    Zip                  |    71101-4502
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    Country              |    US
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    Telephone            |    318-658-9637
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    Fax                  |    318-425-9189
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Provider Business Mailing Address
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    Address Line         |    1725 ELIZABETH AVE 
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    City                 |    SHREVEPORT
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    State                |    LA
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    Zip                  |    71101-4502
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    Country              |    US
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    Telephone            |    318-658-9637
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    Fax                  |    318-425-9189
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Authorized Official
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    Title or Position    |    MANAGING PARTNER
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    Name                 |    MR. CHRISTOPHER A SANTORA 
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    Credential           |    RDMS,RVT,ARRT
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    Telephone            |    318-658-9637
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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       |    01957841
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    License Number State |    LA
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Taxonomy #2
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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 |    LA
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