Organization
HERITAGE IMAGING, INC.
Active
Other names
MRI Mobile
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBRA KAYE EWAN (ADMINISTRATOR)
(208) 947-7000
Entity
Organization
Contact information
Practice address
12554 W. BRIDGER ST. SUITE 118, BOISE, ID 83713-1582
(208) 947-7000
(208) 947-6942
Mailing address
12554 W. BRIDGER ST. SUITE 118, BOISE, ID 83713-1582
(208) 947-7000
(208) 947-6942
Taxonomy
Speciality
Code
Description
License number
State
261QR0208X
Mobile Radiology Clinic/Center
Primary
—
—
Other
Enumeration date
07/31/2020
Last updated
07/31/2020
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