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MISSOURI IMAGING INC NPI 1164480836


NPI Information

NPI: 1164480836
Provider Name: MISSOURI IMAGING, INC

Doing Business As: BRIDGETON MRI & IMAGING CENTER, LLC

Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

Address:
12121 SAINT CHARLES ROCK RD
BRIDGETON, MO
ZIP 63044
Phone: (314) 291-5050
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MISSOURI IMAGING, INC is a diagnostic radiology radiology in Bridgeton, MO. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. MISSOURI IMAGING, INC NPI is 1164480836. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Bridgeton Mri & Imaging Center, Llc.

The provider's business location address is:

12121 SAINT CHARLES ROCK RD
BRIDGETON, MO
ZIP 63044-602
Phone: (314) 291-5050
Fax: (314) 291-8209

The provider's authorized official is Daniel J Schaefer .
The authorized official title is Coo and has the following contact phone number (770) 300-0101.

The enumeration date for this NPI number is 5/3/2006 and was last updated on 12/1/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12085R0202XRadiologyDiagnostic RadiologyMISSOURIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1717224307MEDICAIDMISSOURI
2470000936OTHERMEDICARE RR
3000093035MEDICARE PIN
4610049400OTHERDOL
5194035OTHERMISSOURIBCBS
67190102OTHERAETNA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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