MEDICARE: E PLUS PET IMAGING XVIII LP

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

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	:	1679526800
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	E PLUS PET IMAGING XVIII LP

Provider Business Mailing Address
First Line	:	1915 WILMINGTON DR UNIT 101
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80528-6101
Country	:	US
Telephone Number	:	970-204-0202
Fax Number	:	970-204-0208

Provider Business Practice Location Address
First Line	:	1915 WILMINGTON DR
Second Line	:	SUITE 101
City	:	FORT COLLINS
State	:	CO
Zip	:	80528-3008
Country	:	US
Telephone Number	:	970-204-0202
Fax Number	:	970-204-0208

Authorized Official
Title or Position	:	EXECUTIVE VICE PRESIDENT & CFO
Name	:	CHAOQIANG LIN
Credential	:
Telephone Number	:	214-587-4079

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	12/02/2025

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