MEDICARE: TOPEKA IMAGING, 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	261QM1200X	Magnetic Resonance Imaging (MRI) Clinic/Center

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	470000865	OTHER	KS	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
3	110566	OTHER	KS	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1487626073
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOPEKA IMAGING, LLC

Provider Business Mailing Address
First Line	:	5648 SW 29TH ST
Second Line	:
City	:	TOPEKA
State	:	KS
Zip	:	66614-2443
Country	:	US
Telephone Number	:	785-228-3800
Fax Number	:	785-228-3981

Provider Business Practice Location Address
First Line	:	5648 SW 29TH ST
Second Line	:
City	:	TOPEKA
State	:	KS
Zip	:	66614-2443
Country	:	US
Telephone Number	:	785-228-3800
Fax Number	:	785-228-3981

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	MR. NICHOLAS M DEGENNARO
Credential	:
Telephone Number	:	816-853-8667

Provider Enumeration Date	:	02/07/2006
Last Update Date	:	08/08/2011

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Directions to “TOPEKA IMAGING, LLC ” Practice Location

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