Great River Radiology, INC
Radiology, Diagnostic Radiology in Granite City, IL. Organization (NPI-2).
NPI number1407412752
StatusActive
Last updated in NPPESMay 13, 2019
Details
- NPI
- 1407412752
- Entity type
- Organization (NPI-2)
- Legal business name
- Great River Radiology, INC
- Organization subpart
- No
- Enumeration date
- May 13, 2019
- Last updated
- May 13, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2085R0202X | Radiology, Diagnostic Radiology | – | – | Yes |
Practice location
2100 Madison AveGranite City, IL 62040
Phone 618-798-3281
Mailing address
739 Pinehurst DriveNew Braunfels, TX 78130
Authorized official
John Zabrowski
President
3143039484
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