Provider Demographics
NPI:1073560983
Name:MED IMAGING, INC
Entity Type:Organization
Organization Name:MED IMAGING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER - BUSINESS DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:
Authorized Official - Last Name:NIMROD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-335-5047
Mailing Address - Street 1:PO BOX 554
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38702-0554
Mailing Address - Country:US
Mailing Address - Phone:662-335-5047
Mailing Address - Fax:662-335-5077
Practice Address - Street 1:1700 WALKER LN
Practice Address - Street 2:SUITE 5
Practice Address - City:GREENVILLE
Practice Address - State:MS
Practice Address - Zip Code:38701-7360
Practice Address - Country:US
Practice Address - Phone:662-335-5047
Practice Address - Fax:662-335-5077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonographyGroup - Single Specialty
No2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Single Specialty
No2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular SonographyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00125078Medicaid
MSP00188359OtherRAILROAD MEDICARE ID
MS00125078Medicaid
MSP00188359OtherRAILROAD MEDICARE ID
MSP00188359OtherRAILROAD MEDICARE ID