# SHORT PUMP IMAGING LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Independence Park Imaging
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982651543
- **Authorized official:** MR. LAVELLE R HARDIN (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (615) 344-8203

## Contact information

- **Practice address:** 4200 GREYBULL DR STE 100, RICHMOND, VA 23233-7555
- **Practice address phone:** (804) 217-9729
- **Mailing address:** 2000 HEALTH PARK DR, BRENTWOOD, TN 37027-4692
- **Mailing address phone:** (615) 373-7406

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1200X | Magnetic Resonance Imaging (MRI) Clinic/Center | — | NULL | — |
| 261QR0200X | Radiology Clinic/Center | — | NULL | Yes |
| 261QR0206X | Mammography Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 05/28/2006
- **Last updated:** 02/26/2025