Provider Demographics
NPI:1033109129
Name:WESTERN HILLS OPEN MRI, LLC
Entity Type:Organization
Organization Name:WESTERN HILLS OPEN MRI, LLC
Other - Org Name:PROSCAN IMAGING WESTSIDE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR DIRECTOR, CORPORATE ADMINIST.
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:E
Authorized Official - Last Name:AMAYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-924-5174
Mailing Address - Street 1:6125 HARRISON AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45247-2812
Mailing Address - Country:US
Mailing Address - Phone:513-699-5565
Mailing Address - Fax:513-699-5564
Practice Address - Street 1:6125 HARRISON AVE
Practice Address - Street 2:SUITE A
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45247-2812
Practice Address - Country:US
Practice Address - Phone:513-699-5565
Practice Address - Fax:513-699-5564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-28
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0640IC2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000351219OtherANTHEM PIN
OHP00300862OtherRAILROAD MEDICARE
OH2202413Medicaid
KY7100009600Medicaid
OHP00300862OtherRAILROAD MEDICARE