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NPI Code Detail

MEDICARE: HIGH COUNTRY IMAGING,INC

MEDICARE: HIGH COUNTRY IMAGING,INC
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
1261QR0200XRadiology Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14113524OTHERTNBLUE CROSS BLUE SHIELD NE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

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

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Directions to “HIGH COUNTRY IMAGING,INC ” Practice Location

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