# DES PERES SQUARE IMAGING CENTER LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ORTHOPEDIC ASSOCIATES LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1134120454
- **Legal business name:** ORTHOPEDIC ASSOCIATES LLC
- **Authorized official:** MR. LARRY W POLLEY (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (314) 569-0612

## Contact information

- **Practice address:** 1050 OLD DES PERES RD, SUITE 75, SAINT LOUIS, MO 63131-1873
- **Practice address phone:** (314) 569-2412
- **Practice address fax:** (314) 569-1655
- **Mailing address:** 1050 OLD DES PERES RD, SUITE 100, SAINT LOUIS, MO 63131-1873
- **Mailing address phone:** (314) 569-2412
- **Mailing address fax:** (314) 569-1655

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1200X | Magnetic Resonance Imaging (MRI) Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/09/2005
- **Last updated:** 03/09/2011