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General NPI Number Information
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NPI Number | 1538167192
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Entity Type | Organization
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Legal Business Name | JACKSONVILLE MOBILE IMAGING SERVICES INC
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Dates
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Enumeration Date | 07/08/2005
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Last Update Date | 04/15/2008
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Provider Practice Location Address
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Address Line | 4237 SALISBURY RD SUITE 306
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City | JACKSONVILLE
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State | FL
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Zip | 32216-8029
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Country | US
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Telephone | 904-296-0353
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Fax | 904-296-9403
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Provider Business Mailing Address
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Address Line | 4237 SALISBURY RD SUITE 306
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City | JACKSONVILLE
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State | FL
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Zip | 32216-8029
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Country | US
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Telephone | 904-296-0353
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Fax | 904-296-9403
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DAVID JOHNSON
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Credential | RT. NMT.
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Telephone | 904-545-3591
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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 | HCC3853
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License Number State | FL
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