Provider Demographics
NPI:1649422742
Name:MEDICAL IMAGING OF RICHMOND, LLC
Entity Type:Organization
Organization Name:MEDICAL IMAGING OF RICHMOND, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-447-2575
Mailing Address - Street 1:8921 THREE CHOPT RD STE 104
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-4601
Mailing Address - Country:US
Mailing Address - Phone:804-447-2575
Mailing Address - Fax:804-447-2579
Practice Address - Street 1:8921 THREE CHOPT RD STE 104
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-4601
Practice Address - Country:US
Practice Address - Phone:804-447-2575
Practice Address - Fax:804-447-2579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA56759261QR0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile