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General NPI Number Information
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NPI Number | 1679572333
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Entity Type | Organization
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Legal Business Name | OPEN MRI OF SOUTHERN VA
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Dates
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Enumeration Date | 07/15/2005
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Last Update Date | 09/08/2009
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Provider Practice Location Address
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Address Line | 1509 WEST THIRD STREET
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City | FARMVILLE
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State | VA
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Zip | 23901-2649
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Country | US
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Telephone | 434-315-0306
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Fax | 434-315-0307
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Provider Business Mailing Address
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Address Line | PO BOX 35695
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City | RICHMOND
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State | VA
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Zip | 23235-0695
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Country | US
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Telephone | 804-327-9242
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Fax | 904-327-9812
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JAMES L PERKINS JR.
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Credential |
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Telephone | 804-915-4602
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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