# KENAI PENINSULA IMAGING CENTER LLC

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

## Provider details

- **NPI number:** 1780132753
- **Authorized official:** SCOTT L CARLSON BA (PRESIDENT)
- **Authorized official phone:** (907) 394-9120

## Contact information

- **Practice address:** 100 TRADING BAY RD STE 7, KENAI, AK 99611
- **Practice address phone:** (360) 771-7458
- **Mailing address:** 100 TRADING BAY RD STE 7, KENAI, AK 99611-7786
- **Mailing address phone:** (907) 335-4674
- **Mailing address fax:** (907) 335-1967

## Taxonomy

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

## Other

- **Enumeration date:** 09/19/2016
- **Last updated:** 08/14/2018