Organization
CHESTERFIELD IMAGING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAVELLE R HARDIN (CREDENTIALING COORDINATOR)
(615) 344-8203
Entity
Organization
Contact information
Practice address
13636 HULL STREET RD, MIDLOTHIAN, VA 23112-2108
(804) 639-5489
(804) 639-1389
Mailing address
13636 HULL STREET RD, MIDLOTHIAN, VA 23112-2108
(804) 639-5489
(804) 639-1389
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
—
—
261QR0200X
Radiology Clinic/Center
Primary
—
—
261QR0206X
Mammography Clinic/Center
—
—
Other
Enumeration date
05/28/2006
Last updated
11/30/2007
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