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General NPI Number Information
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NPI Number | 1730262825
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Entity Type | Organization
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Legal Business Name | ANDERSON MOBILE IMAGING,LLC.
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 210 W STONE AVE
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City | GREENVILLE
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State | SC
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Zip | 29609-5452
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Country | US
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Telephone | 678-654-1560
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1718
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City | CARTERSVILLE
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State | GA
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Zip | 30120-1679
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Country | US
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Telephone | 678-654-1560
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JAMES HOWARD MOON
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Credential | RT
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Telephone | 678-654-1560
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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 |
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License Number State | SC
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