# ALLEGIANCE MEDICAL X-RAY LLC

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

## Provider details

- **NPI number:** 1205159761
- **Authorized official:** MR. TONY B CAMILLO (MANAGING PARTNER)
- **Authorized official phone:** (314) 772-1441

## Contact information

- **Practice address:** 2331 HAMPTON AVE, SAINT LOUIS, MO 63139-2908
- **Practice address phone:** (314) 772-1441
- **Practice address fax:** (314) 772-0600
- **Mailing address:** 2331 HAMPTON AVE, ST LOUIS, MO 63139
- **Mailing address phone:** (314) 772-1441
- **Mailing address fax:** (314) 772-0600

## Taxonomy

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

## Other

- **Enumeration date:** 03/11/2010
- **Last updated:** 03/11/2010