MOUNTAIN STATES HEALTH ALLIANCE – NPI #1104158054
Radiology

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

Health Care Provider Taxonomy Code for Radiology

MOUNTAIN STATES HEALTH ALLIANCE is a radiologist located in LEBANON, VA. NPPES has assigned the NPI number 1104158054 to MOUNTAIN STATES HEALTH ALLIANCE on February 03, 2010. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 2085R0202X from the Health Care Provider Taxonomy code set, which is classified as Radiology, specializing in Diagnostic Radiology

The NPI profile was last updated on Apr 16, 2026. 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 MOUNTAIN STATES HEALTH ALLIANCE below.

NPI Profile for
MOUNTAIN STATES HEALTH ALLIANCE

NPI Number
1104158054
Enumeration Date

(more than 16 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
MOUNTAIN STATES HEALTH ALLIANCE
Primary location
58 CARROLL ST
LEBANON, VA 24266-3600
Phone: (276) 883-8101 Fax: (276) 889-4336
Mailing address
PO BOX 3600
LEBANON, VA 24266-0200
Phone: (276) 883-8101 Fax: (276) 889-4336
Organization Subpart
No
Authorized Official
EDDIE GREENE
AVP/ADMINISTRATOR
Phone: (246) 883-8101
Updated
Certification Date
Apr 16, 2026

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
2085R0202X
- Radiology / Diagnostic 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.