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Contact Information

WHITE MOUNTAIN IMAGING, LLC
5448 HIGHWAY 260
LAKESIDE, AZ85929-5739
 Phone: 928-537-2077
 Fax: 928-537-5282
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Magnetic Resonance Imaging Radiologic Technologist

2471M1202X
Indicates primary specialty

NPI Profile & details for WHITE MOUNTAIN IMAGING, LLC

NPI Number 1750368890
LBN Legal business name WHITE MOUNTAIN IMAGING, LLC
Authorized official BRIAN HOEFLE - (BOARD MEMBER)
Entity Organization
Organization subpart 1 No
Enumeration date 12/29/2005
Last updated 08/22/2020 - About 6 years ago
Identifiers
AZ License # OTC5724
AZ Medicaid 918972
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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