Healthcare Provider Details
I. General information
NPI: 1700862331
Provider Name (Legal Business Name): METRO MRI CENTER LIMITED PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/15/2005
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
615 VALLEY VIEW DR
MOLINE IL
61265-6150
US
IV. Provider business mailing address
PO BOX 4030
ROCK ISLAND IL
61204-4030
US
V. Phone/Fax
- Phone: 815-315-1718
- Fax:
- Phone: 815-315-1718
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0200X |
| Taxonomy | Radiology Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KAREN
MARIE
VAUGHN
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 629-317-1465