Healthcare Provider Details
I. General information
NPI: 1457357501
Provider Name (Legal Business Name): OPENSIDED MRI OF NEW ORLEANS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/23/2005
Last Update Date: 01/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 GALLERIA BLVD STE 715
METAIRIE LA
70001-7512
US
IV. Provider business mailing address
1 GALLERIA BLVD STE 715
METAIRIE LA
70001-7512
US
V. Phone/Fax
- Phone: 504-837-6736
- Fax: 504-837-0835
- Phone: 888-749-6736
- Fax: 504-837-0835
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2471M1202X |
| Taxonomy | Magnetic Resonance Imaging Radiologic Technologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM1200X |
| Taxonomy | Magnetic Resonance Imaging (MRI) Clinic/Center |
| License Number | 454551 |
| License Number State | LA |
VIII. Authorized Official
Name:
LINDA
RHODES
Title or Position: OFFICER TREASURER
Credential:
Phone: 804-217-7114