SOUTHTOWNE IMAGING CENTER LLC
NPI 1104991918
Clinic/Center - Radiology in Potosi, MO

Active since November 21, 2006
20 SOUTHTOWNE DR, POTOSI, MO 63664(573) 436-6736(573) 436-7321 Get Directions Write a Review

NPPES record last updated: February 17, 2015. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Southtowne Imaging Center Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHTOWNE IMAGING CENTER LLC (NPI 1104991918) is a healthcare organization registered as a radiology in Potosi, Missouri and active in the NPI registry since November 2006. The organization lists Henry Boots, Owner/manager, as its authorized official.

NPPES Registry Identity

NPI1104991918
Entity TypeOrganization
Primary Taxonomy261QR0200X
Legal Business NameSOUTHTOWNE IMAGING CENTER LLC
Location Address20 SOUTHTOWNE DRPotosi, MO 63664-5729
Mailing Address20 Southtowne DrPotosi, MO 63664-5729 · (573) 436-6736 · Fax (573) 436-7321
Fax(573) 436-7321
Organization SubpartNo
Authorized OfficialHenry BootsOwner/manager · (573) 315-9109
Enumeration DateNovember 21, 2006
Last NPPES UpdateFebruary 17, 2015
NPI 1104991918 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · RadiologyAmbulatory Health Care Facilities
Taxonomy Code261QR0200X
20 SOUTHTOWNE DR, Potosi, MO 63664

Other Identifiers 5

Other59787MO · Healthcare Usa Number
OtherP00277531MO · Railroad Medicare Number
Other269801MO · Ghp Number
Medicare PIN000047057MO
Medicaid710002502MO

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinic/Center (Radiology)
20 SOUTHTOWNE DR
POTOSI, MO 63664

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southtowne Imaging Center LLC's NPI number?

The NPI number for Southtowne Imaging Center LLC is 1104991918. It was assigned to this organization in the NPPES registry on November 21, 2006.

Where is Southtowne Imaging Center LLC located?

Southtowne Imaging Center LLC is located at 20 Southtowne Dr, Potosi, MO 63664. The listed phone number is (573) 436-6736.

What is Southtowne Imaging Center LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Radiology, with taxonomy code 261QR0200X.

When was this NPI record last updated?

The NPPES record for Southtowne Imaging Center LLC was last updated on February 17, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.