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General NPI Number Information
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NPI Number | 1427184845
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Entity Type | Organization
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Legal Business Name | MOBILERAY INC
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1886 GOLA DR
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City | FAYETTEVILLE
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State | NC
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Zip | 28301-0522
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Country | US
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Telephone | 910-488-7752
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Fax | 910-221-7037
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Provider Business Mailing Address
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Address Line | 1886 GOLA DR
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City | FAYETTEVILLE
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State | NC
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Zip | 28301-0522
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Country | US
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Telephone | 910-488-7752
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Fax | 910-221-7037
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Authorized Official
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Title or Position | CHEIF OF OPERATIONS
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Name | MR. EMERY EARLE GIBBS
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Credential | RT-R
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Telephone | 910-488-7752
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 247100000X
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Taxonomy Name | Radiologic Technologist
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License Number | 285746
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License Number State | NC
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