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General NPI Number Information
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NPI Number | 1083686240
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Entity Type | Organization
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Legal Business Name | MOBILE RAD, LLC
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Dates
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Enumeration Date | 02/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1000 E WALNUT ST SUITE 621A
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City | PERKASIE
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State | PA
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Zip | 18944-5444
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Country | US
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Telephone | 215-453-7360
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Fax | 215-453-7362
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Provider Business Mailing Address
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Address Line | 3 CABOT PL UNIT 9
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City | STOUGHTON
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State | MA
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Zip | 02072-4612
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Country | US
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Telephone | 800-636-9729
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Fax | 781-341-0053
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ALLAN E SMITH
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Credential |
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Telephone | 800-636-9729
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number |
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License Number State |
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