Provider Demographics
NPI:1609265792
Name:RIVER BEND IMAGING LLC
Entity type:Organization
Organization Name:RIVER BEND IMAGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:STAGG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-270-7077
Mailing Address - Street 1:4241 VETERANS MEMORIAL BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-5430
Mailing Address - Country:US
Mailing Address - Phone:504-459-3201
Mailing Address - Fax:048-835-3845
Practice Address - Street 1:490 BELLE TERRE BLVD
Practice Address - Street 2:
Practice Address - City:LA PLACE
Practice Address - State:LA
Practice Address - Zip Code:70068-1700
Practice Address - Country:US
Practice Address - Phone:504-915-4741
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-13
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA00018990261QM1200X
261QM1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)