Provider Demographics
NPI:1578677142
Name:ADVANCED MEDICAL TESTING SYSTEMS, INC.
Entity Type:Organization
Organization Name:ADVANCED MEDICAL TESTING SYSTEMS, INC.
Other - Org Name:THE IMAGING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP/COO
Authorized Official - Prefix:
Authorized Official - First Name:JAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GREIWE
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:314-837-5489
Mailing Address - Street 1:235 DUNN RD
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63031-7928
Mailing Address - Country:US
Mailing Address - Phone:314-837-2882
Mailing Address - Fax:314-837-6465
Practice Address - Street 1:235 DUNN RD
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031-7928
Practice Address - Country:US
Practice Address - Phone:314-837-2882
Practice Address - Fax:314-837-6465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1217 CITY-FLORISSANT261QR0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mammography