Healthcare Provider Details

I. General information

NPI: 1114118171
Provider Name (Legal Business Name): ZOOMX MOBILE DIAGNOSTIC SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2007
Last Update Date: 08/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30230 ORCHARD LAKE RD SUITE 100
FARMINGTON HILLS MI
48334-2267
US

IV. Provider business mailing address

30230 ORCHARD LAKE RD SUITE 100
FARMINGTON HILLS MI
48334-2267
US

V. Phone/Fax

Practice location:
  • Phone: 248-538-9444
  • Fax: 248-851-8585
Mailing address:
  • Phone: 248-538-9444
  • Fax: 248-851-8585

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: MR. LEO SAUL EISENBERG
Title or Position: MEMBER/MANAGER
Credential:
Phone: 248-538-9444