Provider Demographics
NPI:1154653152
Name:OIS METROPOLITAN IMAGING LLC
Entity Type:Organization
Organization Name:OIS METROPOLITAN IMAGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:A
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:912-303-0165
Mailing Address - Street 1:1 JOHNSTON ST
Mailing Address - Street 2:STE 12
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-5531
Mailing Address - Country:US
Mailing Address - Phone:912-303-0165
Mailing Address - Fax:912-354-5119
Practice Address - Street 1:503 EISENHOWER DR
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-2668
Practice Address - Country:US
Practice Address - Phone:912-303-0165
Practice Address - Fax:912-354-5119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-02
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody ImagingGroup - Single Specialty
No2085D0003XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic NeuroimagingGroup - Single Specialty
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear RadiologyGroup - Single Specialty
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Single Specialty
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAF67488Medicare UPIN
GAE97460Medicare UPIN
GAH09037Medicare UPIN
GAD21820Medicare UPIN
GAE96315Medicare UPIN
GAF24863Medicare UPIN
GAF06432Medicare UPIN
GAE84902Medicare UPIN