Organization
PRESBYTERIAN IMAGING CENTERS LLC
Active
Other names
Presbyterian Diagnostic Center - Monroe
Organization subpart
No
Provider details
NPI number
Authorized official
FRED M HARGETT (EVP CFO)
(704) 384-5184
Entity
Organization
Contact information
Practice address
2000 WELLNESS BOULEVARD, STE 110, MONROE, NC 28110-7764
(704) 316-1180
(704) 316-1181
Mailing address
PO BOX 60598, CHARLOTTE, NC 28260-0598
(866) 659-1211
(336) 774-1751
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016M6
BCBS
NC
01
—
2881790E
PTAN
—
05
—
5917804
—
NC
01
—
615320700
DOL
NC
01
—
NPB425
SC MEDICAID
NC
01
—
P00187889
RR MEDICARE
NC
Enumeration date
08/20/2008
Last updated
09/13/2012
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