# QUALITY MEDICAL IMAGING OF IDAHO INC

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

## Provider details

- **NPI number:** 1528489044
- **Authorized official:** MR. ROGER C FASELT (PRESIDENT)
- **Authorized official phone:** (702) 839-1133

## Contact information

- **Practice address:** 1420 E 3RD AVE STE 203, POST FALLS, ID 83854-7580
- **Practice address phone:** (866) 508-4870
- **Practice address fax:** (866) 627-4071
- **Mailing address:** 2490 PROFESSIONAL CT, SUITE 110, LAS VEGAS, NV 89128-0835
- **Mailing address phone:** (702) 839-1133
- **Mailing address fax:** (702) 629-4711

## Taxonomy

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

## Other

- **Enumeration date:** 12/31/2013
- **Last updated:** 10/25/2021