Provider Demographics
NPI:1235155821
Name:HARDIN COUNTY IMAGING, LLC
Entity Type:Organization
Organization Name:HARDIN COUNTY IMAGING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JANNICE
Authorized Official - Middle Name:O
Authorized Official - Last Name:AARON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-222-3281
Mailing Address - Street 1:120 E ADAMS ST
Mailing Address - Street 2:STE 4
Mailing Address - City:LAGRANGE
Mailing Address - State:KY
Mailing Address - Zip Code:40031-1278
Mailing Address - Country:US
Mailing Address - Phone:502-222-3281
Mailing Address - Fax:502-225-5796
Practice Address - Street 1:1107 WOODLAND DR
Practice Address - Street 2:STE 102
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-2789
Practice Address - Country:US
Practice Address - Phone:270-769-6665
Practice Address - Fax:270-769-0322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody ImagingGroup - Multi-Specialty
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear RadiologyGroup - Multi-Specialty
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYCA7639OtherRAILROAD MEDICARE GROUP
KY65936601Medicaid
KY9438Medicare ID - Type UnspecifiedNEW HORIZONS MEDICAL CTR
KY6963Medicare Oscar/Certification
KY6917Medicare ID - Type Unspecified
KY65936601Medicaid
KYCA7639OtherRAILROAD MEDICARE GROUP