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General NPI Number Information
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NPI Number | 1669388153
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Entity Type | Organization
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Legal Business Name | OMNIRAD LLC
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Dates
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Enumeration Date | 08/24/2026
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Last Update Date | 08/24/2026
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Provider Practice Location Address
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Address Line | 1324 LOCUST ST APT 415
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City | PHILADELPHIA
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State | PA
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Zip | 19107-5644
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Country | US
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Telephone | 914-443-7437
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Fax |
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Provider Business Mailing Address
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Address Line | 1324 LOCUST ST APT 415
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City | PHILADELPHIA
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State | PA
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Zip | 19107-5644
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Country | US
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Telephone | 914-443-7437
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | LARS PAUL HANDAGO
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Credential |
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Telephone | 914-443-7437
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #3
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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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Taxonomy #4
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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