# MDS DIGITAL PORTABLE X-RAY INC

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

## Provider details

- **NPI number:** 1962523696
- **Authorized official:** MUNEER HASAN (PRESIDENT)
- **Authorized official phone:** (773) 544-1249

## Contact information

- **Practice address:** 10300 W LINCOLN AVE, SUITE LL, WEST ALLIS, WI 53227-2100
- **Practice address phone:** (414) 321-6666
- **Practice address fax:** (888) 734-0535
- **Mailing address:** 10300 W LINCOLN AVE, SUITE LL, WEST ALLIS, WI 53227-2100
- **Mailing address phone:** (414) 321-6666
- **Mailing address fax:** (888) 734-0535

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 291U00000X | Clinical Medical Laboratory | — | WI | — |
| 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | XM 111590 | WI | Yes |

## Other

- **Enumeration date:** 04/02/2007
- **Last updated:** 07/21/2022