=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386658052
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COMMUNITY MRI SERVICES, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/28/2006
-----------------------------------------------------
Last Update Date | 06/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 110 N 37TH ST SUITE 302
-----------------------------------------------------
City | NORFOLK
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68701-3283
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-379-2810
-----------------------------------------------------
Fax | 702-379-4075
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2829 UNIVERSITY DR S STE 201
-----------------------------------------------------
City | FARGO
-----------------------------------------------------
State | ND
-----------------------------------------------------
Zip | 58103-6050
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 701-297-0305
-----------------------------------------------------
Fax | 701-235-9660
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER BILLING CLINICAL SERVICES
-----------------------------------------------------
Name | CATHERINE CAILLIER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 701-234-0112
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM1200X
-----------------------------------------------------
Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------