# PROFESSIONAL PORTABLE RADIOLOGIC SERVICES, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PPX, Professional Portable X-ray
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336716075
- **Authorized official:** BRUCE ALLEN JOHNSON (VP - AO)
- **Authorized official phone:** (303) 589-4149

## Contact information

- **Practice address:** 540 STATE ROUTE 10 STE 1, RANDOLPH, NJ 07869-2033
- **Practice address phone:** (866) 895-2119
- **Practice address fax:** (952) 915-9597
- **Mailing address:** 755 CLIFF RD E, BURNSVILLE, MN 55337-1545
- **Mailing address phone:** (952) 915-9779
- **Mailing address fax:** (952) 915-9597

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | — | NULL | Yes |

## Other

- **Enumeration date:** 06/10/2021
- **Last updated:** 03/31/2025