Organization
OPEN MRI OF FREDERICK 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
1560 OPOSSUMTOWN PIKE, FREDERICK, MD 21702-4748
(240) 379-6177
(240) 379-6190
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
M219
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6803016-000
—
WV
Enumeration date
02/01/2006
Last updated
08/22/2020
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