Healthcare Provider Details

I. General information

NPI: 1508849431
Provider Name (Legal Business Name): OHIO MOBILE X-RAY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2005
Last Update Date: 08/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5525 SCHULTZ DR STE B
SYLVANIA OH
43560-2383
US

IV. Provider business mailing address

5525 SCHULTZ DR STE B
SYLVANIA OH
43560-2383
US

V. Phone/Fax

Practice location:
  • Phone: 440-942-1110
  • Fax: 440-942-0608
Mailing address:
  • Phone: 440-942-1110
  • Fax: 440-942-0608

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: MUNEER HASAN
Title or Position: V. PRESIDENT
Credential:
Phone: 773-544-1249