MEDICARE: DIRECT MOBILE IMAGING, 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
1	335V00000X	Portable X-ray and/or Other Portable Diagnostic Imaging Supplier

General Provider Information

NPI Number	:	1891972147
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIRECT MOBILE IMAGING, INC.

Provider Business Mailing Address
First Line	:	702 DECATUR ST
Second Line	:
City	:	ALVORD
State	:	TX
Zip	:	76225-5085
Country	:	US
Telephone Number	:	940-577-2230
Fax Number	:	940-427-2749

Provider Business Practice Location Address
First Line	:	702 DECATUR ST
Second Line	:
City	:	ALVORD
State	:	TX
Zip	:	76225-5085
Country	:	US
Telephone Number	:	940-427-2247
Fax Number	:	940-427-2749

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	MR. BENJAMIN L HURST
Credential	:	RDCS, RVT, EMTP
Telephone Number	:	940-427-2247

Provider Enumeration Date	:	01/29/2008
Last Update Date	:	06/02/2008

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