MEDICARE: ARIZONA ADVANCED IMAGING CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0200X	Radiology Clinic/Center	OTC3591	AZ
2	261QM1200X	Magnetic Resonance Imaging (MRI) Clinic/Center	OTC3591	AZ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	DC2759	OTHER	AZ	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124078431
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARIZONA ADVANCED IMAGING CENTER LLC

Provider Business Mailing Address
First Line	:	4566 E INVERNESS AVE STE 102
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85206-4633
Country	:	US
Telephone Number	:	480-308-7718
Fax Number	:	480-308-7717

Provider Business Practice Location Address
First Line	:	4566 E INVERNESS AVE
Second Line	:	SUITE 102
City	:	MESA
State	:	AZ
Zip	:	85206-4633
Country	:	US
Telephone Number	:	480-380-7718
Fax Number	:	480-308-7717

Authorized Official
Title or Position	:	CEO
Name	:	SEAN ZAHNISER
Credential	:
Telephone Number	:	480-308-7718

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	02/20/2019

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Directions to “ARIZONA ADVANCED IMAGING CENTER LLC ” Practice Location

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