| Name: | Cahaba Valley Imaging, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 02 Jan 2009 (16 years ago) |
| Entity Number: | 000-428-966 |
| Register Number: | 000428966 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Registered Office Street Address: | 502 MONTGOMERY HWY STE 101VESTAVIA HILLS, AL 35216 |
| Registered Office Street Address ZIP Code: | 35216 |
| Principal Address: | VESTAVIA HILLS, AL |
Activities
RADIOLOGICAL/IMAGING SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1215268446 | 2010-01-28 | 2010-01-28 | 502 MONTGOMERY HWY, SUITE 101, VESTAVIA HILLS, AL, 352161862, US | 201 RACQUET CLUB LANE, PELHAM, AL, 35124, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 205-418-1212 |
| Fax | 2054181214 |
Authorized person
| Name | DR. CHARLES MICHAEL MEAD |
| Role | PRESIDENT |
| Phone | 2058230882 |
Taxonomy
| Taxonomy Code | 2085B0100X - Body Imaging Physician |
| License Number | 17189 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 2085D0003X - Diagnostic Neuroimaging (Radiology) Physician |
| License Number | 17189 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 2085N0904X - Nuclear Radiology Physician |
| License Number | 17189 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 2085R0202X - Diagnostic Radiology Physician |
| License Number | 17189 |
| State | AL |
| Is Primary | Yes |
| Taxonomy Code | 2085R0204X - Vascular & Interventional Radiology Physician |
| License Number | 17189 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 2085U0001X - Diagnostic Ultrasound Physician |
| License Number | 17189 |
| State | AL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | PROVIDER NPI - PHILLIP ARTHUR TRIANTOS, MD |
| Number | 1104821297 |
| State | AL |
| Issuer | PROVIDER NPI - SANDRA BALK MARTIN, MD |
| Number | 1043215114 |
| State | AL |
| Issuer | PROVIDER NPI - CHARLES MICHAEL MEAD, MD |
| Number | 1205833761 |
| State | AL |
| Name | Role |
|---|---|
| MEAD, C MICHAEL | Agent |
| Name | Role |
|---|---|
| MEAD, C MICHAEL | Member |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
