Healthcare Provider Details

I. General information

NPI: 1164829347
Provider Name (Legal Business Name): TENNESSEE MOBILE DIAGNOSTICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2014
Last Update Date: 09/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2874 ELM HILL PIKE
NASHVILLE TN
37214-3718
US

IV. Provider business mailing address

3701 JARVIS AVE
SKOKIE IL
60076-4019
US

V. Phone/Fax

Practice location:
  • Phone: 847-626-0800
  • Fax: 847-626-0819
Mailing address:
  • Phone: 847-626-0800
  • Fax: 847-626-0819

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: ALEEM ABBASI
Title or Position: SECRETARY
Credential:
Phone: 615-891-7164