Provider Demographics
NPI:1770778623
Name:EXEMPLA SOUTHWEST IMAGING CENTER, LLC
Entity type:Organization
Organization Name:EXEMPLA SOUTHWEST IMAGING CENTER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:REGIONAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-304-8949
Mailing Address - Street 1:13402 W COAL MINE AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-5402
Mailing Address - Country:US
Mailing Address - Phone:303-403-6550
Mailing Address - Fax:303-403-6559
Practice Address - Street 1:13402 W COAL MINE AVE STE 100
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-5402
Practice Address - Country:US
Practice Address - Phone:303-403-6550
Practice Address - Fax:303-403-6559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-12
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology