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General NPI Number Information
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NPI Number | 1912942616
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Entity Type | Organization
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Legal Business Name | HIGH COUNTRY IMAGING,INC
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Dates
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Enumeration Date | 06/17/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1987B S SHADY ST
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City | MOUNTAIN CITY
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State | TN
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Zip | 37683-2021
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Country | US
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Telephone | 423-727-0266
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Fax | 423-727-0366
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Provider Business Mailing Address
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Address Line | 1987B S SHADY ST
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City | MOUNTAIN CITY
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State | TN
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Zip | 37683-2021
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Country | US
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Telephone | 423-727-0266
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Fax | 423-727-0366
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. PAUL E SAJDAK
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Credential |
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Telephone | 423-727-0266
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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