Provider Demographics
NPI:1003156019
Name:MOBILE X RAY INC
Entity Type:Organization
Organization Name:MOBILE X RAY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:C
Authorized Official - Last Name:NAGIA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:248-613-5315
Mailing Address - Street 1:24381 ORCHARD LAKE RD
Mailing Address - Street 2:STE C
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48336-1917
Mailing Address - Country:US
Mailing Address - Phone:248-613-5315
Mailing Address - Fax:
Practice Address - Street 1:24381 ORCHARD LAKE RD
Practice Address - Street 2:STE C
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-1917
Practice Address - Country:US
Practice Address - Phone:248-613-5315
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-28
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI335V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherALL PENDING