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General NPI Number Information
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NPI Number | 1417129032
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Entity Type | Organization
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Legal Business Name | STAT PORTABLE X-RAY OF OHIO LIMITED LIABILITY COMPANY
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Dates
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Enumeration Date | 03/25/2008
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Last Update Date | 12/24/2018
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Provider Practice Location Address
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Address Line | 20575 CENTER RIDGE RD SUITE 506
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City | ROCKY RIVER
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State | OH
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Zip | 44116-3422
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Country | US
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Telephone | 718-217-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 21118 UNION TURNOIKE
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City | OAKLAND GARDENS
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State | NY
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Zip | 11364
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Country | US
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Telephone | 718-217-8000
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | MR. ALEX PLATSCHEK
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Credential |
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Telephone | 718-217-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335V00000X
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Taxonomy Name | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
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License Number |
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License Number State |
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