Provider Demographics
NPI:1144424193
Name:MRS MOBILE RADIOLOGIC SERVICE LTD
Entity Type:Organization
Organization Name:MRS MOBILE RADIOLOGIC SERVICE LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SHALOSKY
Authorized Official - Suffix:
Authorized Official - Credentials:RT
Authorized Official - Phone:330-447-4953
Mailing Address - Street 1:419 E FRONT ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:OH
Mailing Address - Zip Code:44622-1869
Mailing Address - Country:US
Mailing Address - Phone:330-447-4953
Mailing Address - Fax:
Practice Address - Street 1:419 E FRONT ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:OH
Practice Address - Zip Code:44622-1869
Practice Address - Country:US
Practice Address - Phone:330-447-4953
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHR2537365335V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier