Provider Demographics
NPI:1417129032
Name:STAT PORTABLE X-RAY OF OHIO LIMITED LIABILITY COMPANY
Entity Type:Organization
Organization Name:STAT PORTABLE X-RAY OF OHIO LIMITED LIABILITY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:PLATSCHEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-217-8000
Mailing Address - Street 1:21118 UNION TURNOIKE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11364
Mailing Address - Country:US
Mailing Address - Phone:718-217-8000
Mailing Address - Fax:
Practice Address - Street 1:20575 CENTER RIDGE RD
Practice Address - Street 2:SUITE 506
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-3422
Practice Address - Country:US
Practice Address - Phone:718-217-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-25
Last Update Date:2018-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier