Provider Demographics
NPI:1245208016
Name:IMAGING CENTRAL, L.L.C.
Entity Type:Organization
Organization Name:IMAGING CENTRAL, L.L.C.
Other - Org Name:TOLEDO OPEN MRI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DESSNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-474-4064
Mailing Address - Street 1:3103 EXECUTIVE PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-1372
Mailing Address - Country:US
Mailing Address - Phone:419-474-4064
Mailing Address - Fax:419-472-2772
Practice Address - Street 1:7111 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43617-1116
Practice Address - Country:US
Practice Address - Phone:419-841-7070
Practice Address - Fax:419-843-6686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-09
Last Update Date:2017-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0869IC261QM1200X, 261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2336449Medicaid
OHP00046045OtherRR MEDICARE
OH000000333765OtherANTHEM
OH000000333765OtherANTHEM