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General NPI Number Information
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NPI Number | 1548058605
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Entity Type | Organization
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Legal Business Name | MOBILE IMAGING, LLC
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Dates
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Enumeration Date | 04/29/2025
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 2211 5TH ST STE 117
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City | MERIDIAN
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State | MS
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Zip | 39301-5845
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Country | US
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Telephone | 601-621-4522
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Fax | 601-621-4615
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Provider Business Mailing Address
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Address Line | 2211 5TH ST STE 117
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City | MERIDIAN
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State | MS
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Zip | 39301-5845
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Country | US
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Telephone | 601-621-4522
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Fax | 601-621-4615
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Authorized Official
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Title or Position | OWNER
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Name | CHARLES MATTHEW HANEY
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Credential |
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Telephone | 601-621-4522
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 |
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