Provider Demographics
NPI:1275862161
Name:GLOBAL OPEN IMAGING CENTERS INC
Entity Type:Organization
Organization Name:GLOBAL OPEN IMAGING CENTERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GORDON
Authorized Official - Middle Name:
Authorized Official - Last Name:FENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-707-8614
Mailing Address - Street 1:6349 BEACH BLVD STE 1A
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-2707
Mailing Address - Country:US
Mailing Address - Phone:904-707-8614
Mailing Address - Fax:
Practice Address - Street 1:6349 BEACH BLVD STE 1A
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-2707
Practice Address - Country:US
Practice Address - Phone:904-707-8614
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-24
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1000028650335V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier