Healthcare Provider Details
I. General information
NPI: 1760968945
Provider Name (Legal Business Name): WASHINGTON OPEN MRI INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/11/2018
Last Update Date: 07/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7399 HANOVER PKWY
GREENBELT MD
20770-3657
US
IV. Provider business mailing address
15005 SHADY GROVE RD STE 110
ROCKVILLE MD
20850-6341
US
V. Phone/Fax
- Phone: 301-220-3003
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM1200X |
| Taxonomy | Magnetic Resonance Imaging (MRI) Clinic/Center |
| License Number | M374 |
| License Number State | MD |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | M374 |
| License Number State | MD |
VIII. Authorized Official
Name:
ALYSON
MOST
Title or Position: D/O
Credential:
Phone: 301-424-4888