MOUNTAIN VALLEY IMAGING LLC NPI 1578789525

NPI Information

NPI: 1578789525
Provider Name: MOUNTAIN VALLEY IMAGING LLC
Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

Address:
450 E MAIN ST
REXBURG, ID
ZIP 83440
Phone: (208) 359-6508
Get Directions

MOUNTAIN VALLEY IMAGING LLC is a diagnostic radiology radiology in Rexburg, ID. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. MOUNTAIN VALLEY IMAGING LLC NPI is 1578789525. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

450 E MAIN ST
REXBURG, ID
ZIP 83440-048
Phone: (208) 359-6508
Fax: (208) 356-3066

The provider's authorized official is David Victor Hansen .
The authorized official title is Owner and has the following contact phone number (208) 359-6508.

The enumeration date for this NPI number is 4/18/2007 and was last updated on 5/6/2008.

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
1	2085R0202X	Radiology	Diagnostic Radiology			Yes

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
1	1375264	MEDICARE ID-TYPE UNSPECIFIED		MEDICARE
2	1156471-00	MEDICAID	WYOMING
3	71910	OTHER	IDAHO	BLUE CROSS

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: 11/14/2023

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »