Organization
WEST STANLY IMAGING LLC
Active
Other names
Atrium Health Imaging Locust
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN FREEMAN (PRESIDENT)
(704) 984-4393
Entity
Organization
Contact information
Practice address
103 STANLY PKWY, SUITE E, LOCUST, NC 28097-7704
(704) 781-0003
Mailing address
PO BOX 686, ALBEMARLE, NC 28002-0686
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
293D00000X
Physiological Laboratory
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020XF
BCBS OF NORTH
NC
05
—
8105034
—
NC
01
—
P00670112
RAILROAD MEDICARE
—
Enumeration date
04/30/2008
Last updated
09/15/2021
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