Organization
MDS DIGITAL PORTABLE X-RAY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MUNEER HASAN (PRESIDENT)
(773) 544-1249
Entity
Organization
Contact information
Practice address
10300 W LINCOLN AVE, SUITE LL, WEST ALLIS, WI 53227-2100
(414) 321-6666
(888) 734-0535
Mailing address
10300 W LINCOLN AVE, SUITE LL, WEST ALLIS, WI 53227-2100
(414) 321-6666
(888) 734-0535
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
—
WI
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
XM 111590
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42508600
—
WI
Enumeration date
04/02/2007
Last updated
07/21/2022
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