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NPI Code Detail

MEDICARE: ELITE MOBILE RADIOLOGY & EKG SERVICE, INC

MEDICARE: ELITE MOBILE RADIOLOGY & EKG SERVICE, 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
1335V00000XPortable X-ray and/or Other Portable Diagnostic Imaging Supplier167099NV

General Provider Information

NPI Number : 1609980184
Entity Type Code : Organization
Provider Name (Legal Business Name) : ELITE MOBILE RADIOLOGY & EKG SERVICE, INC
Provider Business Mailing Address
First Line : PO BOX 50538
Second Line :
City : SPARKS
State : NV
Zip : 89435-0538
Country : US
Telephone Number : 775-690-9729
Fax Number : 775-851-2797
Provider Business Practice Location Address
First Line : 1250 EL MONTE CT
Second Line :
City : RENO
State : NV
Zip : 89521-4117
Country : US
Telephone Number : 775-690-9729
Fax Number : 775-851-2797
Authorized Official
Title or Position : DIRECTOR
Name : MR. TIMOTHY R. TROKE
Credential : X-RAY TECH
Telephone Number : 775-690-9729
Provider Enumeration Date : 08/19/2006
Last Update Date : 08/22/2020

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