Organization
OPEN MRI OF WASHINGTON COUNTY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACE D KELLER (TREASURER)
(724) 925-2280
Entity
Organization
Contact information
Practice address
4165 WASHINGTON RD, MC MURRAY, PA 15317-2522
(724) 941-7900
(724) 941-3233
Mailing address
PO BOX 450, NEW STANTON, PA 15672-0450
(724) 925-2330
(724) 925-7816
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
N/A
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10087335300001
—
PA
01
—
1563981
HIGHMARK BCBS
PA
Enumeration date
05/31/2006
Last updated
08/22/2020
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