Provider Demographics
NPI:1336503341
Name:CENTRAL OREGON MAGNETIC RESONANCE IMAGING LLC
Entity Type:Organization
Organization Name:CENTRAL OREGON MAGNETIC RESONANCE IMAGING LLC
Other - Org Name:CENTRAL OREGON MRI
Other - Org Type:Other Name
Authorized Official - Title/Position:SENIOR VICE PRESIDENT OF ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:KRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:HARVEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-598-3218
Mailing Address - Street 1:PO BOX 6059
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97708-6059
Mailing Address - Country:US
Mailing Address - Phone:541-382-6633
Mailing Address - Fax:541-382-2719
Practice Address - Street 1:1253 NW CANAL BLVD STE 101
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-1334
Practice Address - Country:US
Practice Address - Phone:541-548-8131
Practice Address - Fax:541-382-2719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-06
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty