Healthcare Provider Details

I. General information

NPI: 1710907316
Provider Name (Legal Business Name): PRECISION IMAGING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 01/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6000 EXECUTIVE BLVD SUITE 302
ROCKVILLE MD
20852-3803
US

IV. Provider business mailing address

6000 EXECUTIVE BLVD SUITE 302
ROCKVILLE MD
20852-3803
US

V. Phone/Fax

Practice location:
  • Phone: 301-656-7226
  • Fax: 301-656-7225
Mailing address:
  • Phone: 301-656-7226
  • Fax: 301-656-7225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. RALPH WILLIAMSON FAIRBANKS III
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 301-656-7225