Provider Demographics
NPI:1619209996
Name:MIDWEST RADIOLOGY SERVICES, LLC
Entity Type:Organization
Organization Name:MIDWEST RADIOLOGY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT & COO
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:A
Authorized Official - Last Name:SNEAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-787-1350
Mailing Address - Street 1:16091 SWINGLEY RIDGE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-2056
Mailing Address - Country:US
Mailing Address - Phone:636-787-1350
Mailing Address - Fax:636-519-7965
Practice Address - Street 1:16091 SWINGLEY RIDGE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-2056
Practice Address - Country:US
Practice Address - Phone:636-787-1350
Practice Address - Fax:636-519-7965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-11
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty