MEDICARE: HORIZON OPEN MRI - COLUMBUS EAST

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

General Provider Information

NPI Number	:	1801015516
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HORIZON OPEN MRI - COLUMBUS EAST

Provider Business Mailing Address
First Line	:	6465 E BROAD ST
Second Line	:	STE 210
City	:	COLUMBUS
State	:	OH
Zip	:	43213-1576
Country	:	US
Telephone Number	:	614-860-0930
Fax Number	:

Provider Business Practice Location Address
First Line	:	6465 E BROAD ST
Second Line	:	STE 210
City	:	COLUMBUS
State	:	OH
Zip	:	43213-1576
Country	:	US
Telephone Number	:	614-860-0930
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DENY RADEFELD
Credential	:
Telephone Number	:	941-493-4008

Provider Enumeration Date	:	04/24/2007
Last Update Date	:	08/22/2020

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