Healthcare Provider Details

I. General information

NPI: 1245160357
Provider Name (Legal Business Name): PERIPHERAL MOBILE IMAGING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 LAKEFOREST BLVD
GAITHERSBURG MD
20877-2611
US

IV. Provider business mailing address

101 LAKEFOREST BLVD
GAITHERSBURG MD
20877-2611
US

V. Phone/Fax

Practice location:
  • Phone: 202-590-0873
  • Fax:
Mailing address:
  • Phone: 202-590-0873
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156F00000X
TaxonomyTechnician/Technologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. LILIANE V PAMI
Title or Position: MANAGER OF OPERATIONS
Credential: RVT
Phone: 202-590-0873