MEDICARE: WINCHESTER OPEN MRI LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0200X	Radiology Clinic/Center

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	470001355	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	442512	OTHER	VA	ANTHEM BCBS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275527939
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WINCHESTER OPEN MRI LLC

Provider Business Mailing Address
First Line	:	PO BOX 71303
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28272-1303
Country	:	US
Telephone Number	:	330-564-2660
Fax Number	:

Provider Business Practice Location Address
First Line	:	160 EXETER DR
Second Line	:	SUITE 104
City	:	WINCHESTER
State	:	VA
Zip	:	22603-8614
Country	:	US
Telephone Number	:	540-431-3567
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RONALD REPASKY
Credential	:	MD
Telephone Number	:	540-545-4674

Provider Enumeration Date	:	09/08/2005
Last Update Date	:	12/14/2023

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Directions to “WINCHESTER OPEN MRI LLC ” Practice Location

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