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General NPI Number Information
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NPI Number | 1699154997
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Entity Type | Organization
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Legal Business Name | IMAGING GROUP CENTER INC
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Dates
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Enumeration Date | 05/20/2015
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Last Update Date | 05/20/2015
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Provider Practice Location Address
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Address Line | 2727 PACES FERRY RD SE
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City | ATLANTA
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State | GA
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Zip | 30339-4053
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Country | US
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Telephone | 404-426-4665
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Fax | 404-521-4959
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Provider Business Mailing Address
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Address Line | 2727 PACES FERRY RD SE
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City | ATLANTA
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State | GA
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Zip | 30339-4053
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Country | US
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Telephone | 404-426-4665
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Fax | 404-521-4959
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Authorized Official
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Title or Position | OWNER
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Name | YESDEL ACOSTA
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Credential |
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Telephone | 404-426-4665
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State | GA
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