MEDICARE: VANGUARD IMAGING PARTNERS, 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	261QM1200X	Magnetic Resonance Imaging (MRI) Clinic/Center	1252IC	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00437849	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1225061526
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VANGUARD IMAGING PARTNERS, LLC

Provider Business Mailing Address
First Line	:	PO BOX 635500
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45263-0001
Country	:	US
Telephone Number	:	937-306-1463
Fax Number	:

Provider Business Practice Location Address
First Line	:	2619 COMMONS BLVD
Second Line	:
City	:	BEAVERCREEK
State	:	OH
Zip	:	45431-3817
Country	:	US
Telephone Number	:	937-306-1463
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT AND CEO
Name	:	MR. JOSEPH L BRYWCZYNSKI
Credential	:
Telephone Number	:	937-208-9676

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	04/01/2008

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