Organization
COMMUNITY MRI SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL J HOFER SR. (PRESIDENT)
(701) 297-0305
Entity
Organization
Contact information
Practice address
1252 WASHINGTON AVE, DETROIT LAKES, MN 56501-3928
(218) 847-6316
(218) 847-6303
Mailing address
3223 32ND AVENUE S, SUITE 201, FARGO, ND 58103-6278
(701) 297-0305
(701) 235-9660
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1026467
PREFERRED ONE
MN
01
—
141965700
US DEPT OF LABOR
MN
01
—
1602881
MEDICA
MN
01
—
269M3CO
MINNESOTA BCBS
MN
05
—
650069200
—
MN
Enumeration date
07/22/2006
Last updated
12/20/2011
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