Provider Demographics
NPI:1588753297
Name:HIGH TECH IMAGING CENTER INC
Entity type:Organization
Organization Name:HIGH TECH IMAGING CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:REVA
Authorized Official - Middle Name:
Authorized Official - Last Name:ESMAILI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-265-7213
Mailing Address - Street 1:1510 FOREST AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-1517
Mailing Address - Country:US
Mailing Address - Phone:334-256-7213
Mailing Address - Fax:
Practice Address - Street 1:1510 FOREST AVE
Practice Address - Street 2:SUITE B
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-1517
Practice Address - Country:US
Practice Address - Phone:334-256-7213
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance ImagingGroup - Single Specialty
No247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistGroup - Single Specialty
No2471C3401XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistComputed TomographyGroup - Single Specialty
No2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiographyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51521424OtherBCBS
AL51521426OtherBCBS
AL51533081OtherBCBS
AL51521427OtherBCBS
AL51521429OtherBCBS
AL51521431OtherBCBS
AL51526731OtherBCBS
AL51521430OtherBCBS
ALP00388885OtherRAIL ROAD MEDICARE
AL51521432OtherBCBS
AL51521425OtherBCBS
AL51521428OtherBCBS
AL51521432OtherBCBS
AL51521431OtherBCBS