# KING'S MEDICAL IMAGING CREVE COEUR, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Advanced Imaging Creve Coeur
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063415073
- **Authorized official:** MS. V. RENAE COYNE (DIRECTOR OF BILLING)
- **Authorized official phone:** (330) 653-3968

## Contact information

- **Practice address:** 11756 OLIVE STREET RD, CREVE COEUR, MO 63141
- **Practice address phone:** (314) 569-3900
- **Practice address fax:** (314) 569-2734
- **Mailing address:** 1894 GEORGETOWN RD, HUDSON, OH 44236-4058
- **Mailing address phone:** (330) 653-3968
- **Mailing address fax:** (330) 656-1660

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 293D00000X | Physiological Laboratory | — | — | Yes |

## Other

- **Enumeration date:** 05/23/2005
- **Last updated:** 08/22/2020