1447404462 NPI number — MOBILE MEDICAL IMAGING SERVICES INC.

Table of content: (NPI 1447404462)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447404462 NPI number — MOBILE MEDICAL IMAGING SERVICES INC.

Organization/Personal Information

Employer Identification Number (EIN):
N/A
Provider Organization Name:
MOBILE MEDICAL IMAGING SERVICES INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447404462
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/05/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1601 CONGRESS ST
Provider Second Line Business Mailing Address:
SUITE 3
Provider Business Mailing Address City Name:
PORTLAND
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04102-2102
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
207-774-0885
Provider Business Mailing Address Fax Number:
207-774-7694

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1601 CONGRESS ST
Provider Second Line Business Practice Location Address:
SUITE 3
Provider Business Practice Location Address City Name:
PORTLAND
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04102-2102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-774-0885
Provider Business Practice Location Address Fax Number:
207-774-7694
Provider Enumeration Date:
11/05/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
NOBLE
Authorized Official First Name:
STEVEN
Authorized Official Middle Name:
M.
Authorized Official Title or Position:
PRESIDENT/TREASURER
Authorized Official Telephone Number:
207-774-0720

Provider Taxonomy Codes

  • Taxonomy code: 2085U0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)