Organization
PRESBYTERIAN IMAGING CENTERS LLC
Active
Other names
Presbyterian Imaging Center University
Organization subpart
No
Provider details
NPI number
Authorized official
FRED M HARGETT (EVP CFO)
(704) 384-5184
Entity
Organization
Contact information
Practice address
8401 MEDICAL PLAZA DR, STE 110, CHARLOTTE, NC 28262-8797
(704) 384-1580
Mailing address
2085 FRONTIS PLAZA BLVD, WINSTON-SALEM, NC 27103-5614
(336) 277-7226
(336) 277-9795
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
—
—
261QR0200X
Radiology Clinic/Center
Primary
—
—
293D00000X
Physiological Laboratory
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16-42368
UHC
—
05
—
5917808
—
NC
01
—
615320705
NC DOL
NC
01
—
P00471051
RAILROAD MEDICARE
—
Enumeration date
05/15/2006
Last updated
10/14/2011
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