# MOBILE MEDICAL IMAGING OF COASTAL GEORGIA, LLC

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

## Provider details

- **NPI number:** 1053858761
- **Authorized official:** JAMIE L HUBBARD RT(R) ARRT (OWNER)
- **Authorized official phone:** (912) 295-5611

## Contact information

- **Practice address:** 5906 HWY 21 S, UNIT 4, SPRINGFIELD, GA 31326-5505
- **Practice address phone:** (912) 295-5611
- **Practice address fax:** (844) 895-6771
- **Mailing address:** 5906 HWY 21 S, UNIT 4, RINCON, GA 31326-5505
- **Mailing address phone:** (912) 295-5611
- **Mailing address fax:** (844) 895-6771

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | — | NULL | Yes |

## Other

- **Enumeration date:** 01/20/2017
- **Last updated:** 04/29/2017