Healthcare Provider Details

I. General information

NPI: 1306178454
Provider Name (Legal Business Name): REMJOY OUTPATIENT DIAGNOSTIC SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2010
Last Update Date: 01/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 1ST AVE NE STE 210
ROCHESTER MN
55906-4170
US

IV. Provider business mailing address

1500 1ST AVE NE STE 210
ROCHESTER MN
55906-4170
US

V. Phone/Fax

Practice location:
  • Phone: 507-424-0055
  • Fax:
Mailing address:
  • Phone: 507-424-0055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: MS. SAIDA H OMAR
Title or Position: TECHNOLOGIST
Credential:
Phone: 703-362-4429