Provider Demographics
NPI:1326057365
Name:PALMARIS IMAGING, LLC
Entity Type:Organization
Organization Name:PALMARIS IMAGING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-728-2222
Mailing Address - Street 1:16091 SWINGLEY RIDGE RD
Mailing Address - Street 2:STE. 100
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-2056
Mailing Address - Country:US
Mailing Address - Phone:636-728-2222
Mailing Address - Fax:636-519-7965
Practice Address - Street 1:1000 W 10TH ST
Practice Address - Street 2:DEPT. OF RADIOLOGY
Practice Address - City:ROLLA
Practice Address - State:MO
Practice Address - Zip Code:65401-2905
Practice Address - Country:US
Practice Address - Phone:636-728-2222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-07
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025263100Medicaid
NCPENDINGMedicaid
VA1326057365Medicaid
VA246769OtherBCBS VIRGINIA
KY65945743Medicaid
KY65945743Medicaid
VAC10045Medicare PIN
KYDC0577Medicare PIN
VA=========004OtherTRICARE NORTH
KY9950Medicare ID - Type Unspecified
NCPENDINGMedicaid