| Organization Name: | MEDICA IMAGING, LLC |
| NPI Number: | 1013956416 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARY KAY BAKER (VP OF OPERATIONS) |
| Mailing Address: | 925 Sanders Rd Suite B Cumming |
| State: | GA US |
| Postal Code: | 300417945 |
| Phone Number: | 6788452150 |
| Fax Number: | 6788452148 |
| NPI Enumeration Date: | 06/05/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0200X |
| License Number: | 2100666 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Radiology |
| Taxonomy Definition: | |