Healthcare Provider Details

I. General information

NPI: 1073516134
Provider Name (Legal Business Name): MEDFUND LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2803 WRIGHTSBORO RD STE 18
AUGUSTA GA
30909-3917
US

IV. Provider business mailing address

240 N WASHINGTON BLVD
SARASOTA FL
34236-5945
US

V. Phone/Fax

Practice location:
  • Phone: 706-729-9800
  • Fax: 706-729-8980
Mailing address:
  • Phone: 941-925-3490
  • Fax: 941-953-4452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. MARTIN J KERN
Title or Position: SENIOR VICE PRESIDENT
Credential:
Phone: 941-925-3490