Healthcare Provider Details
I. General information
NPI: 1003804345
Provider Name (Legal Business Name): MOBILE MOLECULAR IMAGING LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/11/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date: 12/15/2006
Reactivation Date: 01/09/2007
III. Provider practice location address
100 MEMORIAL HOSPITAL DR STE 1E
MOBILE AL
36608
US
IV. Provider business mailing address
PO BOX 7687
MOBILE AL
36670-0627
US
V. Phone/Fax
- Phone: 251-316-3868
- Fax: 251-316-3583
- Phone: 251-460-0243
- Fax: 251-460-0375
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085B0100X |
| Taxonomy | Body Imaging Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
JOSEPH
R
ZURFLUH
Title or Position: MANAGER
Credential:
Phone: 251-633-0573