MEDICARE: PHYSICIANS MOBILE X-RAY, INC

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	2085U0001X	Diagnostic Ultrasound Physician

General Provider Information

NPI Number	:	1043635840
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICIANS MOBILE X-RAY, INC

Provider Business Mailing Address
First Line	:	6310 ALLENTOWN BLVD STE 102
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17112-2739
Country	:	US
Telephone Number	:	717-561-4940
Fax Number	:	717-561-4999

Provider Business Practice Location Address
First Line	:	6310 ALLENTOWN BLVD STE 102
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17112-2739
Country	:	US
Telephone Number	:	717-561-4940
Fax Number	:	717-561-4999

Authorized Official
Title or Position	:	CEO
Name	:	TODD GELBAUGH
Credential	:
Telephone Number	:	717-561-4940

Provider Enumeration Date	:	03/03/2014
Last Update Date	:	02/20/2023

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