Provider Demographics
NPI:1487285193
Name:AU HEALTH IMAGING, LLC
Entity type:Organization
Organization Name:AU HEALTH IMAGING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:STOUT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-261-2306
Mailing Address - Street 1:1120 15TH ST # BI1056
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30912-0004
Mailing Address - Country:US
Mailing Address - Phone:706-721-3813
Mailing Address - Fax:706-721-9286
Practice Address - Street 1:3722 WHEELER RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-6638
Practice Address - Country:US
Practice Address - Phone:706-721-8623
Practice Address - Fax:706-721-1439
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AU MEDICAL ASSOCIATES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-01-31
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No293D00000XLaboratoriesPhysiological LaboratoryGroup - Multi-Specialty