Organization
RAINA IMAGING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY A PANKEY RVT (OWNER)
(904) 992-9749
Entity
Organization
Contact information
Practice address
245 LAND GRANT ST UNIT 6, SAINT AUGUSTINE, FL 32092-1698
(904) 992-9749
(904) 212-1508
Mailing address
245 LAND GRANT ST UNIT 6, SAINT AUGUSTINE, FL 32092-1698
(904) 992-9749
(904) 992-8980
Taxonomy
Speciality
Code
Description
License number
State
261QR0208X
Mobile Radiology Clinic/Center
Primary
HCC6547
FL
261QR0208X
Mobile Radiology Clinic/Center
I3794
AL
261QR0208X
Mobile Radiology Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
470000610
RAILROAD MEDICARE PIN
AL
01
—
498797
WELLCARE
FL
01
—
950001085
RAILROAD MEDICARE PIN
FL
01
—
V2104
BC/BS PIN
FL
Enumeration date
02/08/2007
Last updated
10/03/2024
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