MEDICARE: WESTERN HILLS OPEN MRI, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	0640IC	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00300862	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000351219	OTHER	OH	ANTHEM PIN
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033109129
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WESTERN HILLS OPEN MRI, LLC

Provider Business Mailing Address
First Line	:	6125 HARRISON AVE
Second Line	:	SUITE A
City	:	CINCINNATI
State	:	OH
Zip	:	45247-2812
Country	:	US
Telephone Number	:	513-699-5565
Fax Number	:	513-699-5564

Provider Business Practice Location Address
First Line	:	6125 HARRISON AVE
Second Line	:	SUITE A
City	:	CINCINNATI
State	:	OH
Zip	:	45247-2812
Country	:	US
Telephone Number	:	513-699-5565
Fax Number	:	513-699-5564

Authorized Official
Title or Position	:	SR DIRECTOR, CORPORATE ADMINIST.
Name	:	KAREN E AMAYA
Credential	:
Telephone Number	:	513-924-5174

Provider Enumeration Date	:	10/28/2005
Last Update Date	:	03/11/2013

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Directions to “WESTERN HILLS OPEN MRI, LLC ” Practice Location

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