Provider Demographics
NPI:1831632942
Name:NORTHLAND IMAGING, LLC
Entity type:Organization
Organization Name:NORTHLAND IMAGING, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:DANTE
Authorized Official - Middle Name:
Authorized Official - Last Name:PATERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-961-6838
Mailing Address - Street 1:7113 W 135TH ST
Mailing Address - Street 2:# 363
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66223-1238
Mailing Address - Country:US
Mailing Address - Phone:913-961-6838
Mailing Address - Fax:
Practice Address - Street 1:9201 PARALLEL PKWY
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66112-1510
Practice Address - Country:US
Practice Address - Phone:913-334-4410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTHLAND IMAGING, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-11-21
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology