Organization
PIONEER MEDICAL PORTABLE XRAY,LLC
Active
Parent organization
PIONEER MEDICAL, IDTF
Organization subpart
Yes
Provider details
NPI number
Legal business name
PIONEER MEDICAL, IDTF
Authorized official
TED H CRABTREE JR. RT (OWNER)
(601) 550-4611
Entity
Organization
Contact information
Practice address
100 CLARENDON AVE, PETAL, MS 39465-2636
(601) 550-4611
(601) 510-9449
Mailing address
100 CLARENDON AVE, PETAL, MS 39465-2636
(601) 550-4611
(601) 510-9449
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
—
—
Other
Enumeration date
11/03/2009
Last updated
11/10/2009
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