Healthcare Provider Details
I. General information
NPI: 1912180142
Provider Name (Legal Business Name): DMS IMAGING INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/11/2007
Last Update Date: 07/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2101 UNIVERSITY DR N
FARGO ND
58102-1816
US
IV. Provider business mailing address
2101 UNIVERSITY DR N
FARGO ND
58102-1816
US
V. Phone/Fax
- Phone: 701-237-9073
- Fax:
- Phone: 701-237-9073
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM1200X |
| Taxonomy | Magnetic Resonance Imaging (MRI) Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STACIE
R
HEIDEN
Title or Position: CFO
Credential:
Phone: 701-237-9073