# NORTHEAST X-RAY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659578409
- **Authorized official:** CHRISTOPHER M BROWN (OWNER)
- **Authorized official phone:** (260) 484-8414

## Contact information

- **Practice address:** 2928 PARNELL AVE, FORT WAYNE, IN 46805-2500
- **Practice address phone:** (260) 484-8414
- **Mailing address:** 2928 PARNELL AVE, FORT WAYNE, IN 46805-2500
- **Mailing address phone:** (260) 484-8414

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | XT002431 | IN | Yes |

## Other

- **Enumeration date:** 06/27/2007
- **Last updated:** 08/22/2020