Organization
MOBILERAY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EMERY EARLE GIBBS RT-R (CHEIF OF OPERATIONS)
(910) 488-7752
Entity
Organization
Contact information
Practice address
1886 GOLA DR, FAYETTEVILLE, NC 28301-0522
(910) 488-7752
(910) 221-7037
Mailing address
1886 GOLA DR, FAYETTEVILLE, NC 28301-0522
(910) 488-7752
(910) 221-7037
Taxonomy
Speciality
Code
Description
License number
State
247100000X
Radiologic Technologist
Primary
285746
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0181Y
BLUECROSS BLUE SHIELD OF
NC
01
—
220NMEDCAREPRO
ANTHEM BLUE CROSS AND BLU
OH
05
—
3409818
—
NC
Enumeration date
02/27/2007
Last updated
08/22/2020
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