Provider Demographics
NPI:1154116796
Name:NOVANT HEALTH ENTERPRISES IMAGING II, LLC
Entity type:Organization
Organization Name:NOVANT HEALTH ENTERPRISES IMAGING II, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF NOVANT HEALTH VENTURES
Authorized Official - Prefix:MR
Authorized Official - First Name:WADE
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-677-0679
Mailing Address - Street 1:2001 RANDOLPH RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28207-1215
Mailing Address - Country:US
Mailing Address - Phone:704-323-3754
Mailing Address - Fax:704-323-3985
Practice Address - Street 1:2001 RANDOLPH RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-1215
Practice Address - Country:US
Practice Address - Phone:704-323-3754
Practice Address - Fax:704-323-3985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty