Provider Demographics
NPI:1760578496
Name:METRO IMAGING, LLC
Entity Type:Organization
Organization Name:METRO IMAGING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:IV
Authorized Official - Credentials:
Authorized Official - Phone:314-333-6725
Mailing Address - Street 1:11615 OLIVE BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-7274
Mailing Address - Country:US
Mailing Address - Phone:314-993-9555
Mailing Address - Fax:
Practice Address - Street 1:11615 OLIVE BOULEVARD
Practice Address - Street 2:
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141
Practice Address - Country:US
Practice Address - Phone:314-993-9555
Practice Address - Fax:314-993-9550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO326978OtherHEALTHLINK GROUP NUMBER
MO613714OtherHEALTHLINK GROUP NUMBER
IL0006015396OtherBLUE CROSS & BLUE SHIELD
MO184965OtherBLUE CROSS & BLUE SHIELD
MO434256OtherHEALTHLINK GROUP NUMBER
MO12261X12261OtherHEALTHCARE USA GROUP NUMB
MO27190OtherGROUP HEALTH PLAN
MO251201OtherHEALTHLINK GROUP NUMBER
MO375706OtherHEALTHLINK GROUP NUMBER
MO8351085OtherAETNA GROUP NUMBER
MO140091100OtherUS DEPARTMENT OF LABOR
MO1601369OtherUNITED HEALTHCARE
MO000000010625OtherESSENCE HEALTHCARE
MO266417OtherFEDERAL BLACK LUNG
MO711435800Medicaid