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NPI Code Detail

MEDICARE: OHIO IMAGING CENTERS INC

MEDICARE: OHIO IMAGING CENTERS INC
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
12085R0202XDiagnostic Radiology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1821264797
Entity Type Code : Organization
Provider Name (Legal Business Name) : OHIO IMAGING CENTERS INC
Provider Business Mailing Address
First Line : 1930 STATE ROUTE 59
Second Line :
City : KENT
State : OH
Zip : 44240-4112
Country : US
Telephone Number : 330-677-3632
Fax Number : 330-677-8770
Provider Business Practice Location Address
First Line : 158 W MAIN RD
Second Line :
City : CONNEAUT
State : OH
Zip : 44030-2039
Country : US
Telephone Number : 330-677-3632
Fax Number : 330-677-8770
Authorized Official
Title or Position : PRESIDENT
Name : DR. ALBERT J COOK
Credential : MD
Telephone Number : 330-677-3632
Provider Enumeration Date : 05/01/2008
Last Update Date : 05/01/2008

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Directions to “OHIO IMAGING CENTERS INC ” Practice Location

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