Healthcare Provider Details

I. General information

NPI: 1659404416
Provider Name (Legal Business Name): MRI COOPERATIVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 10/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6505 MARKET ST
YOUNGSTOWN OH
44512-3457
US

IV. Provider business mailing address

6414 MARKET ST
YOUNGSTOWN OH
44512-3434
US

V. Phone/Fax

Practice location:
  • Phone: 330-884-2106
  • Fax:
Mailing address:
  • Phone: 330-884-2150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MISS MAUREEN M MCGUIRE
Title or Position: OFFICE MANAGER
Credential: CPC
Phone: 330-884-2150