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General NPI Number Information
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NPI Number | 1104121839
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Entity Type | Organization
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Legal Business Name | PREFERRED MOBILE IMAGING
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Dates
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Enumeration Date | 01/11/2011
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Last Update Date | 03/30/2011
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Provider Practice Location Address
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Address Line | 8680 ASHTON DR
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City | LAURINBURG
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State | NC
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Zip | 28352-0710
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Country | US
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Telephone | 910-318-3557
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Fax | 910-276-3291
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Provider Business Mailing Address
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Address Line | 8680 ASHTON DR
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City | LAURINBURG
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State | NC
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Zip | 28352-0710
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Country | US
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Telephone | 910-318-3557
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Fax | 910-276-3291
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Authorized Official
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Title or Position | OWNER
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Name | MARSHA G JACOBS
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Credential | RCS, RVS
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Telephone | 910-318-3557
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246XC2903X
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Taxonomy Name | Vascular Specialist/Technologist Cardiovascular
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License Number | 25204
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 2471S1302X
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Taxonomy Name | Sonography Radiologic Technologist
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License Number | 25204
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 246XS1301X
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Taxonomy Name | Sonography Specialist/Technologist Cardiovascular
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License Number | 25204
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License Number State | NC
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