Healthcare Provider Details

I. General information

NPI: 1871593541
Provider Name (Legal Business Name): MOBILE X-RAY IMAGING INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

945 EAST PARK DR SUITE 102
HARRISBURG PA
17111
US

IV. Provider business mailing address

945 EAST PARK DR SUITE 102
HARRISBURG PA
17111
US

V. Phone/Fax

Practice location:
  • Phone: 717-561-4940
  • Fax: 717-561-4467
Mailing address:
  • Phone: 717-561-4940
  • Fax: 717-561-4467

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code335V00000X
TaxonomyPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code247100000X
TaxonomyRadiologic Technologist
License Number
License Number StatePA

VIII. Authorized Official

Name: MR. TODD GELBAUGH
Title or Position: PRESIDENT
Credential:
Phone: 717-561-4940