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Contact Information

RURAL IMAGING SOUTHEAST LLC
781 4TH AVE STE A
YORK, AL36925-2103
 Phone: 334-830-7215
 Fax: 334-222-2583
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physiological Laboratory, (Independent Physiological Lab)

293D00000X 47 Independent Diagnostic Testing Facility (IDTF)
Indicates primary specialty

NPI Profile & details for RURAL IMAGING SOUTHEAST LLC

NPI Number 1467623264
LBN Legal business name RURAL IMAGING SOUTHEAST LLC
Authorized official BOBBY BURKETT - (MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 03/19/2008
Last updated 10/28/2008 - About 18 years ago
Identifiers
AL License # I2002
AL Medicaid 009966385
AL Medicaid 529920840
AL Other 51519466 BLUE CROSS BLUE SHIELD
AL Other 051554594 MEDICARE PROVIDER NUMBER
AL Other P00145028 RAILROAD PROVIDER NUMBER
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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