Mobile Medical Radiography and Ekg Inc

Primary specialty

Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X

License

08305 Issued in MA

Legal business name

MOBILE MEDICAL RADIOGRAPHY AND EKG INC

Practice address

109 Rhode Island Rd
Clear Pond Offices
Lakeville, MA 02347-1370

Phone

(508) 923-6171

Fax

(508) 923-6248

NPI assigned

Oct 31, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Minda De Medeiros, MHA

Title

VP of Administrative Services

Phone

(508) 923-6171

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197504000000",
    "number": "1053302042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 RHODE ISLAND RD",
            "address_2": "CLEAR POND OFFICES",
            "city": "LAKEVILLE",
            "state": "MA",
            "postal_code": "023471370",
            "telephone_number": "508-923-6171",
            "fax_number": "508-923-6248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 RHODE ISLAND RD",
            "address_2": "CLEAR POND OFFICES",
            "city": "LAKEVILLE",
            "state": "MA",
            "postal_code": "023471370",
            "telephone_number": "508-923-6171",
            "fax_number": "508-923-6248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE MEDICAL RADIOGRAPHY AND EKG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-31",
        "last_updated": "2007-12-13",
        "status": "A",
        "authorized_official_last_name": "DE MEDEIROS",
        "authorized_official_first_name": "MINDA",
        "authorized_official_title_or_position": "VP OF ADMINISTRATIVE SERVICES",
        "authorized_official_telephone_number": "508-923-6171",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MHA"
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": "MA",
            "license": "08305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "209805",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1536591",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Lakeville, MA
• Providers in Lakeville, MA by specialty
• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.