Organization
ROANOKE IMAGING LLC
Active
Other names
Lewis Gale Imaging at Brambleton
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAVELLE R HARDIN (ANALYST)
(615) 344-8203
Entity
Organization
Contact information
Practice address
4330 BRAMBLETON AVE, ROANOKE, VA 24018-3405
(540) 688-6763
(540) 283-3701
Mailing address
4330 BRAMBLETON AVE, ROANOKE, VA 24018-3405
(540) 688-6763
(540) 283-3701
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1073750816
BCBS
VA
05
—
1073750816
—
VA
Enumeration date
01/15/2009
Last updated
06/09/2009
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