Organization
OPEN MRI OF CONNELLSVILLE 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
2616 MEMORIAL BLVD, CONNELLSVILLE, PA 15425-1418
(724) 620-2812
(724) 620-2815
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
—
—
261QR0200X
Radiology Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018227030003
—
PA
01
—
011682
HIGHMARK BCBS
PA
Enumeration date
12/21/2005
Last updated
09/11/2025
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