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Organization
COULTER IMAGING CENTER LLC
Active
Organization
COULTER IMAGING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANITA TILDEN (MGR)
(806) 358-7149
Entity
Organization
Contact information
Practice address
1900 COULTER ST, UNIT N, AMARILLO, TX 79106-1782
(806) 358-7149
Mailing address
PO BOX 50420, AMARILLO, TX 79159-0420
(806) 358-7149
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
R13716
TX
261QR0206X
Mammography Clinic/Center
R13716
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
080601001
—
TX
01
—
103168100
FIRSTCARE
—
Enumeration date
06/22/2006
Last updated
11/13/2008
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