Healthcare Provider Details

I. General information

NPI: 1477744225
Provider Name (Legal Business Name): R S & J IMAGING, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2007
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34600 CHARDON RD
WILLOUGHBY OH
44094-8480
US

IV. Provider business mailing address

4400 ROCKSIDE RD SUITE 1100
INDEPENDENCE OH
44131-2109
US

V. Phone/Fax

Practice location:
  • Phone: 440-585-6163
  • Fax: 440-944-4346
Mailing address:
  • Phone: 216-464-8484
  • Fax: 216-464-2444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number1058IC
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number1058IC
License Number StateOH

VIII. Authorized Official

Name: MR. RON L CLARK
Title or Position: PRESIDENT & COO
Credential:
Phone: 216-464-8484