Provider Demographics
NPI:1710093687
Name:IMAGING AFFILIATES OF BATON ROUGE, LTD.
Entity Type:Organization
Organization Name:IMAGING AFFILIATES OF BATON ROUGE, LTD.
Other - Org Name:BATON ROUGE IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:R
Authorized Official - Last Name:ASARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-454-3600
Mailing Address - Street 1:8044 SUMMA AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-3411
Mailing Address - Country:US
Mailing Address - Phone:225-761-7278
Mailing Address - Fax:225-767-8121
Practice Address - Street 1:8044 SUMMA AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3411
Practice Address - Country:US
Practice Address - Phone:225-761-7278
Practice Address - Fax:225-767-8121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1948578Medicaid
LA5C338Medicare ID - Type UnspecifiedPROVIDER NUMBER