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General NPI Number Information
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NPI Number | 1639607575
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Entity Type | Organization
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Legal Business Name | MOBILE X-RAY SPECIALISTS, INC.
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Dates
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Enumeration Date | 05/23/2017
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Last Update Date | 05/23/2017
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Provider Practice Location Address
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Address Line | 6706 N 9TH AVE
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City | PENSACOLA
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State | FL
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Zip | 32504-9303
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Country | US
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Telephone | 877-887-3829
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Fax | 888-405-0653
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Provider Business Mailing Address
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Address Line | PO BOX 521292
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City | LONGWOOD
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State | FL
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Zip | 32752-1292
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Country | US
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Telephone | 877-887-3829
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Fax | 888-405-0653
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Authorized Official
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Title or Position | CEO
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Name | MR. KEVIN PATRICK MCDONOUGH
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Credential | R.T. (R) ARRT
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Telephone | 877-887-3829
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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 | FL
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