Organization
WICHITA AREA MOBILE SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES E. FANCHER (OWNER)
(940) 761-2882
Entity
Organization
Contact information
Practice address
2113 KELL BLVD STE E, WICHITA FALLS, TX 76308-1256
(940) 761-2882
Mailing address
2113 KELL BLVD STE E, WICHITA FALLS, TX 76308-1256
(940) 761-2882
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
45-X0009901
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000009998
BCBS OF TEXAS PROVIDER NO
TX
01
—
00000MDXO
BCBS OF TEXAS
—
05
—
178472001
—
TX
01
—
45X0009901
PORT. XRAY MCR ID NO.
TX
01
—
7102000TX76308
BCBS OF MICHIGAN
MI
Enumeration date
07/23/2006
Last updated
06/27/2008
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