# LIBERTY PORTABLE X-RAY OHIO LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LIBERTY PORTABLE X-RAY OHIO LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1578036943
- **Legal business name:** LIBERTY PORTABLE X-RAY OHIO LLC
- **Authorized official:** DANIELLE PHILIPPS (DIRECTOR OF OPERATIONS)
- **Authorized official phone:** (717) 607-1700

## Contact information

- **Practice address:** 1430 OAK HARBOR RD, FREMONT, OH 43420-1025
- **Practice address phone:** (717) 607-1700
- **Practice address fax:** (717) 607-1710
- **Mailing address:** 955 BROADWAY, WOODMERE, NY 11598-1733
- **Mailing address phone:** (717) 607-1700
- **Mailing address fax:** (717) 607-1710

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0208X | Mobile Radiology Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/08/2019
- **Last updated:** 01/28/2024