Provider Demographics
NPI:1770954489
Name:NUCLEAR MEDICINE IMAGING,INC.
Entity type:Organization
Organization Name:NUCLEAR MEDICINE IMAGING,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:PADGETT
Authorized Official - Suffix:
Authorized Official - Credentials:RT(NM)
Authorized Official - Phone:850-703-7416
Mailing Address - Street 1:1845 CANE MILL RD
Mailing Address - Street 2:
Mailing Address - City:CHIPLEY
Mailing Address - State:FL
Mailing Address - Zip Code:32428-3961
Mailing Address - Country:US
Mailing Address - Phone:850-638-8947
Mailing Address - Fax:850-638-8947
Practice Address - Street 1:1845 CANE MILL RD
Practice Address - Street 2:
Practice Address - City:CHIPLEY
Practice Address - State:FL
Practice Address - Zip Code:32428-3961
Practice Address - Country:US
Practice Address - Phone:850-638-8947
Practice Address - Fax:850-638-8947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-08
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2459-1291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory