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General NPI Number Information
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NPI Number | 1265425029
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Entity Type | Organization
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Legal Business Name | NORTH IDAHO MRI
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Dates
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Enumeration Date | 08/26/2005
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Last Update Date | 12/28/2009
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Provider Practice Location Address
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Address Line | 825 W IRONWOOD DR
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City | COEUR D ALENE
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State | ID
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Zip | 83814-2673
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Country | US
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Telephone | 208-666-3119
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Fax | 208-666-3963
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Provider Business Mailing Address
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Address Line | PO BOX 3103
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City | COEUR D ALENE
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State | ID
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Zip | 83816-2525
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Country | US
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Telephone | 208-666-3119
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Fax | 208-666-3963
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Authorized Official
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Title or Position | CFO
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Name | THOMAS J LEGEL
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Credential |
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Telephone | 208-666-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number |
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License Number State |
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