Com-Rad Mobile Imaging, LLC

Primary specialty

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

Legal business name

COM-RAD MOBILE IMAGING, LLC

Practice address

339 Benwood TRL NE
Cleveland, TN 37323-5096

Phone

(423) 650-8353

Fax

(336) 245-0649

NPI assigned

Mar 1, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Mark Minton

Title

President

Phone

(423) 650-8353

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311033600000",
    "number": "1902934110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 BENWOOD TRL NE",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373235096",
            "telephone_number": "423-650-8353",
            "fax_number": "336-245-0649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 BENWOOD TRL NE",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373235096",
            "telephone_number": "423-650-8353",
            "fax_number": "336-245-0649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COM-RAD MOBILE IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2011-07-19",
        "status": "A",
        "authorized_official_last_name": "MINTON",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-650-8353",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3400012",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Cleveland, TN
• Providers in Cleveland, TN by specialty
• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2011; 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.