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General NPI Number Information
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NPI Number | 1518918481
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Entity Type | Organization
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Legal Business Name | PRESBYTERIAN IMAGING CENTERS LLC
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Dates
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Enumeration Date | 05/15/2006
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Last Update Date | 10/14/2011
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Provider Practice Location Address
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Address Line | 8401 MEDICAL PLAZA DR STE 110
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City | CHARLOTTE
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State | NC
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Zip | 28262-8797
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Country | US
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Telephone | 704-384-1580
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Fax |
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Provider Business Mailing Address
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Address Line | 2085 FRONTIS PLAZA BLVD
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City | WINSTON-SALEM
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State | NC
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Zip | 27103-5614
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Country | US
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Telephone | 336-277-7226
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Fax | 336-277-9795
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Authorized Official
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Title or Position | EVP CFO
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Name | FRED M HARGETT
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Credential |
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Telephone | 704-384-5184
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number |
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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