Provider Demographics
NPI:1215400775
Name:ADVANCED MEDICAL IMAGING, LLC
Entity Type:Organization
Organization Name:ADVANCED MEDICAL IMAGING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:SUBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-564-9154
Mailing Address - Street 1:15264 254TH ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-7122
Mailing Address - Country:US
Mailing Address - Phone:816-564-9154
Mailing Address - Fax:
Practice Address - Street 1:4930 OVERLAND DR
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049-4132
Practice Address - Country:US
Practice Address - Phone:785-856-0708
Practice Address - Fax:785-856-0709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-08
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty