BROAD 64 IMAGING LLC – NPI #1316015985
Clinic/Center

BROAD 64 IMAGING LLC is an AHC clinic located in RICHMOND, VA. NPPES has assigned the NPI number 1316015985 to BROAD 64 IMAGING LLC on December 01, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QR0200X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Radiology

The NPI profile was previously updated about 6 years ago on Nov 04, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for BROAD 64 IMAGING LLC below.

NPI Profile for
BROAD 64 IMAGING LLC

NPI Number
1316015985
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
BROAD 64 IMAGING LLC
Primary location
6605 W BROAD ST
SUITE B - GROUND FLOOR
RICHMOND, VA 23230
Phone: (804) 281-0215 Fax:
Mailing address
PO BOX 631146
CINCINNATI, OH 45263-1146
Phone: (513) 952-5002 Fax:
Organization Subpart
No
Authorized Official
KIMBERLY RALSTON
SYSTEM DIRECTOR
Phone: (419) 996-5119
Updated
Certification Date
Nov 04, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QR0200X
- Clinic/Center / Radiology (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.