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Organization
PIONEER MEDICAL PORTABLE XRAY,LLC
Active
Organization
PIONEER MEDICAL PORTABLE XRAY,LLC
Active
Parent organization
PIONEER MEDICAL, IDTF
Organization subpart
Yes
Provider details
NPI number
Legal business name
PIONEER MEDICAL, IDTF
Authorized official
TED H CRABTREE JR. RT (OWNER)
(601) 550-4611
Entity
Organization
Contact information
Practice address
100 CLARENDON AVE, PETAL, MS 39465-2636
(601) 550-4611
(601) 510-9449
Mailing address
100 CLARENDON AVE, PETAL, MS 39465-2636
(601) 550-4611
(601) 510-9449
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
—
NULL
Other
Enumeration date
11/03/2009
Last updated
11/10/2009
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