Provider Demographics
NPI:1427000405
Name:VISTA IMAGING PARTNERS, LLC
Entity type:Organization
Organization Name:VISTA IMAGING PARTNERS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:CECIL
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-336-0945
Mailing Address - Street 1:1301 YMCA DR
Mailing Address - Street 2:SUITE 600
Mailing Address - City:FESTUS
Mailing Address - State:MO
Mailing Address - Zip Code:63028-2655
Mailing Address - Country:US
Mailing Address - Phone:314-336-0945
Mailing Address - Fax:314-336-0949
Practice Address - Street 1:655 CRAIG RD
Practice Address - Street 2:SUITE 112
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-7132
Practice Address - Country:US
Practice Address - Phone:314-336-0945
Practice Address - Fax:314-336-0949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology