Provider Demographics
NPI:1083695068
Name:COMPREHENSIVE IMAGING SERVICES LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE IMAGING SERVICES LLC
Other - Org Name:OPEN MRI OF BOUNTIFUL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KIRK
Authorized Official - Middle Name:
Authorized Official - Last Name:REINITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-210-1885
Mailing Address - Street 1:PO BOX 635051
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-0001
Mailing Address - Country:US
Mailing Address - Phone:866-494-8262
Mailing Address - Fax:
Practice Address - Street 1:1551 RENAISSANCE TOWNE DR
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-7667
Practice Address - Country:US
Practice Address - Phone:801-298-7272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-08
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTW0617Medicaid
UTW0617Medicaid