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General NPI Number Information
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NPI Number | 1588836878
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Entity Type | Organization
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Legal Business Name | MEDICAL IMAGING TEMPORARIES INC
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Dates
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Enumeration Date | 03/27/2008
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Last Update Date | 03/27/2008
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Provider Practice Location Address
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Address Line | 1 S 521 WESTVIEW AVE.
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City | LOMBARD
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State | IL
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Zip | 60148-5058
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Country | US
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Telephone | 630-691-8366
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Fax |
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Provider Business Mailing Address
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Address Line | 1 S 521 WESTVIEW AVE
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City | LOMBARD
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State | IL
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Zip | 60148-5058
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Country | US
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Telephone | 630-691-8366
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RICHARD J IDA SR.
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Credential | R.T.R.
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Telephone | 630-691-8366
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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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