Organization
MOBILE RADIOLOGY ASSOCIATES
Active
Other names
Mobile Radiology
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN H WANAMAKER (PRESIDENT)
(419) 562-8777
Entity
Organization
Contact information
Practice address
124 S SANDUSKY AVE, BUCYRUS, OH 44820-2219
(419) 562-8777
(419) 562-0921
Mailing address
124 S SANDUSKY AVE, BUCYRUS, OH 44820-2219
(419) 562-8777
(419) 562-0921
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
06-L-10811-01
OH
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
1079397
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000226826
ANTHEM BLUE CROSS
OH
05
—
0941717
—
OH
Enumeration date
09/12/2005
Last updated
08/27/2007
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