Organization
FAST RESPONSE PORTABLE IMAGING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAM WEINBERG (OWNER)
(914) 263-3745
Entity
Organization
Contact information
Practice address
10 N MYRTLE AVE, CLEARWATER, FL 33755-4533
(727) 337-6101
(727) 213-6250
Mailing address
100 CHALLENGER RD, SUITE 100, RIDGEFIELD PARK, NJ 07660-2108
(727) 337-6101
(727) 213-6250
Taxonomy
Speciality
Code
Description
License number
State
261QR0208X
Mobile Radiology Clinic/Center
HCC9044
FL
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
HCC9044
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053642314
MEDICARE 855B
KY
Enumeration date
11/30/2010
Last updated
07/15/2016
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