Provider Demographics
NPI:1376029546
Name:WASHINGTON OPEN MRI INC
Entity Type:Organization
Organization Name:WASHINGTON OPEN MRI INC
Other - Org Name:WASHINGTON OPEN MRI - OWINGS MILLS
Other - Org Type:Other Name
Authorized Official - Title/Position:AUTHORIZED DELEGATE
Authorized Official - Prefix:
Authorized Official - First Name:ALYSON
Authorized Official - Middle Name:
Authorized Official - Last Name:MOST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-424-4888
Mailing Address - Street 1:15005 SHADY GROVE RD STE 110
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-6341
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:25 CROSSROADS DR STE 180
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5485
Practice Address - Country:US
Practice Address - Phone:410-356-0343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WASHINGTON OPEN MRI INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-07-11
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDM376261Q00000X, 261QM1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD635LOtherMEDICARE