Provider Demographics
NPI:1467573154
Name:MEDICAL IMAGING NETWORK
Entity Type:Organization
Organization Name:MEDICAL IMAGING NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-921-8381
Mailing Address - Street 1:15245 SHADY GROVE RD
Mailing Address - Street 2:SUITE C125
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3222
Mailing Address - Country:US
Mailing Address - Phone:301-921-8381
Mailing Address - Fax:301-921-8581
Practice Address - Street 1:15245 SHADY GROVE RD
Practice Address - Street 2:SUITE C125
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3222
Practice Address - Country:US
Practice Address - Phone:301-921-8381
Practice Address - Fax:301-921-8581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization