1871593541 NPI number — MOBILE X-RAY IMAGING INC.

Table of content: (NPI 1871593541)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871593541 NPI number — MOBILE X-RAY IMAGING INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MOBILE X-RAY IMAGING 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:
1871593541
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
945 EAST PARK DR
Provider Second Line Business Mailing Address:
SUITE 102
Provider Business Mailing Address City Name:
HARRISBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17111
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-561-4940
Provider Business Mailing Address Fax Number:
717-561-4467

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
945 EAST PARK DR
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
HARRISBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17111
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-561-4940
Provider Business Practice Location Address Fax Number:
717-561-4467
Provider Enumeration Date:
07/26/2005

Additional Information

Authorized Official

Authorized Official Last Name:
GELBAUGH
Authorized Official First Name:
TODD
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
717-561-4940

Provider Taxonomy Codes

  • Taxonomy code: 247100000X , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QR0208X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 335V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 604810100 . This is a "ACS PROVIDER ID" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0015231320004 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 130594 . This is a "MED-PLUS NON-PAR ID" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 50002712 . This is a "CAPITAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 027624300 . This is a "FEDERAL BLACK LUNG ID" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: P00093629 . This is a "RAILROAD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 310243 . This is a "HIGHMARK" identifier . This identifiers is of the category "OTHER".




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