Healthcare Provider Details

I. General information

NPI: 1417971177
Provider Name (Legal Business Name): COMMUNITY OPEN MRI OF AUBURN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 04/09/2024
Certification Date: 04/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 SMITH DR
AUBURN IN
46706-3655
US

IV. Provider business mailing address

196 W SPOTSWOOD AVE
ELKTON VA
22827-1169
US

V. Phone/Fax

Practice location:
  • Phone: 260-925-6736
  • Fax: 260-925-4720
Mailing address:
  • Phone: 804-217-7114
  • Fax: 804-217-7120

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: JOHN STEVEN PLATUSIC
Title or Position: COO
Credential:
Phone: 804-363-1007