Healthcare Provider Details

I. General information

NPI: 1275457970
Provider Name (Legal Business Name): MERIDIAN PORTABLE X-RAY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3524 N MERIDIAN ST STE 101
INDIANAPOLIS IN
46208-4486
US

IV. Provider business mailing address

3524 N MERIDIAN ST STE 101
INDIANAPOLIS IN
46208-4486
US

V. Phone/Fax

Practice location:
  • Phone: 317-496-7137
  • Fax:
Mailing address:
  • Phone: 317-496-7137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335V00000X
TaxonomyPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
License Number
License Number State

VIII. Authorized Official

Name: ELSE L COLE
Title or Position: CEO
Credential:
Phone: 317-496-7137