# ELEVATION MEDICAL IMAGING GILLETTE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003587692
- **Authorized official:** SHAUN ANDRIKOPOULOS (PARTNER)
- **Authorized official phone:** (307) 682-1779

## Contact information

- **Practice address:** 913 E BOXELDER RD, GILLETTE, WY 82718
- **Practice address phone:** (307) 682-1779
- **Practice address fax:** (307) 682-1745
- **Mailing address:** PO BOX 736, WHEAT RIDGE, CO 80034-0736
- **Mailing address phone:** (307) 218-8223
- **Mailing address fax:** (317) 218-8224

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0200X | Radiology Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/23/2021
- **Last updated:** 04/24/2023