Provider Demographics
NPI:1649212002
Name:LA IMAGING SERVICES LLC
Entity type:Organization
Organization Name:LA IMAGING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:BARONET
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:318-473-9917
Mailing Address - Street 1:PO BOX 13260
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71315
Mailing Address - Country:US
Mailing Address - Phone:318-473-9917
Mailing Address - Fax:318-473-9993
Practice Address - Street 1:2209 N BOLTON AVE
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-4408
Practice Address - Country:US
Practice Address - Phone:318-473-9917
Practice Address - Fax:318-473-9993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA746204102006261QR0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1342858Medicaid
LA=========0OtherBCBS
LA=========0OtherBCBS