MEDICARE: VESTAVIA HILLS IMAGING CENTER

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
2	261QM1200X	Magnetic Resonance Imaging (MRI) Clinic/Center

General Provider Information

NPI Number	:	1902859937
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VESTAVIA HILLS IMAGING CENTER

Provider Business Mailing Address
First Line	:	2017 CANYON RD
Second Line	:	SUITE 25
City	:	VESTAVIA HILLS
State	:	AL
Zip	:	35216-1903
Country	:	US
Telephone Number	:	205-824-8262
Fax Number	:	205-824-8264

Provider Business Practice Location Address
First Line	:	2017 CANYON RD
Second Line	:	SUITE 25
City	:	VESTAVIA HILLS
State	:	AL
Zip	:	35216-1903
Country	:	US
Telephone Number	:	205-824-8262
Fax Number	:	205-824-8264

Authorized Official
Title or Position	:	CREDENTIALING
Name	:	MARGARITA L. TORRES
Credential	:
Telephone Number	:	504-459-3220

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	11/13/2020

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