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NPI Code Detail

MEDICARE: EASTSIDE MRI LIMITED PARTNERSHIP

MEDICARE: EASTSIDE MRI LIMITED PARTNERSHIP
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
1261QM1200XMagnetic Resonance Imaging (MRI) Clinic/Center0142ICOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083622898
Entity Type Code : Organization
Provider Name (Legal Business Name) : EASTSIDE MRI LIMITED PARTNERSHIP
Provider Business Mailing Address
First Line : 25001 EMERY RD
Second Line : SUITE 100
City : CLEVELAND
State : OH
Zip : 44128-5626
Country : US
Telephone Number : 216-831-9786
Fax Number : 216-831-2425
Provider Business Practice Location Address
First Line : 2785 SOM CENTER RD
Second Line :
City : WILLOUGHBY HILLS
State : OH
Zip : 44094-6501
Country : US
Telephone Number : 440-944-8887
Fax Number :
Authorized Official
Title or Position : CHIEF FINANCIAL OFFICER
Name : MR. JEFFREY A. KAMPMAN
Credential : CPA
Telephone Number : 216-831-9786
Provider Enumeration Date : 08/04/2006
Last Update Date : 07/15/2011

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