NPI 1588759849

Executive Image INC

Organisation Portable X-ray and/or Other Portable Diagnostic Imaging Supplier Winston Salem, NC

Practice location

Address: 7820 N Point Blvd Suite 101, Winston Salem, NC 27106-3299
Phone: (336) 245-0647
Fax: (336) 245-0649

Authorised official

Name: Diana Goolsby
Title: Owner
Phone: (336) 918-6328

Registered specialties

Portable X-ray and/or Other Portable Diagnostic Imaging Supplier Primary

Suppliers Taxonomy 335V00000X Licence 600495328 (NC)

Other Portable X-ray and/or Other Portable Diagnostic Imaging Supplier providers in North Carolina →

Registry record

NPI: 1588759849
Entity type: Organization
NPI issued: 4 Oct 2006
Record last updated: 15 Jan 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.