Provider Demographics
NPI:1053642314
Name:FAST RESPONSE PORTABLE IMAGING INC
Entity Type:Organization
Organization Name:FAST RESPONSE PORTABLE IMAGING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGARETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOUINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-348-0411
Mailing Address - Street 1:4658 LITWIN ST #A
Mailing Address - Street 2:
Mailing Address - City:FORT CAMPBELL
Mailing Address - State:KY
Mailing Address - Zip Code:42223
Mailing Address - Country:US
Mailing Address - Phone:270-348-0411
Mailing Address - Fax:270-640-8276
Practice Address - Street 1:4658 LITWIN ST # A
Practice Address - Street 2:
Practice Address - City:FORT CAMPBELL
Practice Address - State:KY
Practice Address - Zip Code:42223
Practice Address - Country:US
Practice Address - Phone:270-348-0411
Practice Address - Fax:270-640-8276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-26
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile