Healthcare Provider Details

I. General information

NPI: 1245208016
Provider Name (Legal Business Name): IMAGING CENTRAL, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 05/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7111 W CENTRAL AVE
TOLEDO OH
43617-1116
US

IV. Provider business mailing address

3103 EXECUTIVE PKWY SUITE 200
TOLEDO OH
43606-1372
US

V. Phone/Fax

Practice location:
  • Phone: 419-841-7070
  • Fax: 419-843-6686
Mailing address:
  • Phone: 419-474-4064
  • Fax: 419-472-2772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number0869IC
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number0869IC
License Number StateOH

VIII. Authorized Official

Name: MR. DANIEL DESSNER
Title or Position: MANAGING DIRECTOR
Credential: MD
Phone: 419-474-4064