Provider Demographics
NPI:1073692158
Name:SPRING HILL IMAGING CENTER LLC
Entity Type:Organization
Organization Name:SPRING HILL IMAGING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:W
Authorized Official - Last Name:BREWER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:931-388-1286
Mailing Address - Street 1:P O BOX 1558
Mailing Address - Street 2:SPRING HILL IMAGING CENTER LLC
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38402-1558
Mailing Address - Country:US
Mailing Address - Phone:931-388-1286
Mailing Address - Fax:931-388-7119
Practice Address - Street 1:5421 MAIN ST
Practice Address - Street 2:SUITE C
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174-2499
Practice Address - Country:US
Practice Address - Phone:931-486-3425
Practice Address - Fax:931-489-5844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNODC0000000028261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3736801Medicaid
TN=========OtherEIN
TN3736801Medicare PIN