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General NPI Number Information
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NPI Number | 1538537436
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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 | 09/09/2015
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Last Update Date | 09/09/2015
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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 |
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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 | R40088
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License Number State | TX
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