Provider Demographics
NPI:1669891396
Name:MISSION IMAGING SERVICES, LLC
Entity type:Organization
Organization Name:MISSION IMAGING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:FRANKLIN
Authorized Official - Last Name:AYSCUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-213-1137
Mailing Address - Street 1:PO BOX 602994
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2994
Mailing Address - Country:US
Mailing Address - Phone:828-213-1500
Mailing Address - Fax:828-651-6570
Practice Address - Street 1:149 W PARKER RD
Practice Address - Street 2:SUITE B
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-4673
Practice Address - Country:US
Practice Address - Phone:828-438-2708
Practice Address - Fax:828-438-3634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-09
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCQ469490001Medicare PIN