# ELITE IMAGING OF NORTH COUNTY, LLC

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

## Provider details

- **NPI number:** 1720232192
- **Authorized official:** CECIL S. GRAY (MEMBER)
- **Authorized official phone:** (913) 669-6161

## Contact information

- **Practice address:** 433 LYNN HAVEN LN, HAZELWOOD, MO 63042-1808
- **Practice address phone:** (314) 731-0600
- **Practice address fax:** (314) 731-0601
- **Mailing address:** 433 LYNN HAVEN LN, HAZELWOOD, MO 63042-1808
- **Mailing address phone:** (314) 731-0600
- **Mailing address fax:** (314) 731-0601

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0200X | Radiology Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/11/2008
- **Last updated:** 12/16/2008