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General NPI Number Information
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NPI Number | 1457433526
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Entity Type | Organization
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Legal Business Name | ADVANCED PORTABLE X-RAY
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 3718 JEFFERSON AVE
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City | TEXARKANA
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State | AR
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Zip | 71854-2244
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Country | US
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Telephone | 224-337-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 8235 CHRISTIANA AVE
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City | SKOKIE
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State | IL
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Zip | 60076-2910
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Country | US
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Telephone | 224-337-1000
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Fax | 224-337-0100
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Authorized Official
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Title or Position | CEO
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Name | MR. ETAI SOOLIMAN
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Credential |
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Telephone | 224-337-1000
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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 | R27937
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License Number State | AR
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Taxonomy #2
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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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