Organization Name: | IMAGING RESOURCE CENTERS LTD |
NPI Number: | 1003855909 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHARLES ED YOUNG (OWNER/CEO) |
Mailing Address: | 2991 Newmark Dr Miamisburg |
State: | OH US |
Postal Code: | 453425416 |
Phone Number: | 9378855840 |
Fax Number: | 9378855863 |
NPI Enumeration Date: | 06/06/2006 |
NPI Last Update Date: | 11/28/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0208X |
License Number: | 06-E-04159-01 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Radiology, Mobile |
Taxonomy Definition: |