Provider Demographics
NPI:1275527939
Name:WINCHESTER OPEN MRI LLC
Entity Type:Organization
Organization Name:WINCHESTER OPEN MRI LLC
Other - Org Name:WINCHESTER IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:REPASKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-545-4674
Mailing Address - Street 1:PO BOX 71303
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28272-1303
Mailing Address - Country:US
Mailing Address - Phone:330-564-2660
Mailing Address - Fax:
Practice Address - Street 1:160 EXETER DR
Practice Address - Street 2:SUITE 104
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22603-8614
Practice Address - Country:US
Practice Address - Phone:540-431-3567
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-08
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004997964Medicaid
470001355OtherRAILROAD MEDICARE
VA442512OtherANTHEM BCBS
WV6805007000Medicaid
VAFVA004Medicare PIN