Healthcare Provider Details

I. General information

NPI: 1720272941
Provider Name (Legal Business Name): QUALITY MOBILE IMAGING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2007
Last Update Date: 06/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 5TH AVE STE 2
HUNTINGTON WV
25701-1907
US

IV. Provider business mailing address

501 5TH AVE SUITE 2
HUNTINGTON WV
25701-1900
US

V. Phone/Fax

Practice location:
  • Phone: 800-999-9709
  • Fax:
Mailing address:
  • Phone: 304-523-4172
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335V00000X
TaxonomyPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
License Number335V00000X
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. MICHAEL ALLEN
Title or Position: PRESIDENT
Credential:
Phone: 800-999-9709