Organization
GEODAX IMAGING, LLC
Active
Other names
Morganton Diagnostics
Organization subpart
No
Provider details
NPI number
Authorized official
REGINALD R. SIPE (VP/CFO)
(336) 274-2844
Entity
Organization
Contact information
Practice address
505 E PARKER RD, MORGANTON, NC 28655-5104
(828) 437-5812
(828) 433-8317
Mailing address
3723 W MARKET ST STE B, GREENSBORO, NC 27403-1375
(336) 274-2844
(336) 274-2817
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2881714B
MEDICARE
NC
05
—
8975100
—
NC
Enumeration date
10/19/2007
Last updated
10/19/2007
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