Provider Demographics
NPI:1487657425
Name:KING'S MANAGEMENT & LEASING LLC
Entity Type:Organization
Organization Name:KING'S MANAGEMENT & LEASING LLC
Other - Org Name:LONGVIEW IMAGING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF BILLING
Authorized Official - Prefix:MS
Authorized Official - First Name:V.
Authorized Official - Middle Name:RENAE
Authorized Official - Last Name:BARLOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-528-1828
Mailing Address - Street 1:1894 GEORGETOWN RD
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-4058
Mailing Address - Country:US
Mailing Address - Phone:330-528-1828
Mailing Address - Fax:330-656-1660
Practice Address - Street 1:2901 JUDSON RD
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-1803
Practice Address - Country:US
Practice Address - Phone:903-663-0110
Practice Address - Fax:903-663-0279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-23
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXFTNX03Medicare PIN