Provider Demographics
NPI:1477744225
Name:R S & J IMAGING, INC
Entity Type:Organization
Organization Name:R S & J IMAGING, INC
Other - Org Name:PRECISION DIAGNOSTIC IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & COO
Authorized Official - Prefix:MR
Authorized Official - First Name:RON
Authorized Official - Middle Name:L
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-464-8484
Mailing Address - Street 1:4400 ROCKSIDE RD
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44131-2109
Mailing Address - Country:US
Mailing Address - Phone:216-464-8484
Mailing Address - Fax:216-464-2444
Practice Address - Street 1:34600 CHARDON RD
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-8480
Practice Address - Country:US
Practice Address - Phone:440-585-6163
Practice Address - Fax:440-944-4346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1058IC261QM1200X, 261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0994670Medicaid
OH0994670Medicaid
OH=========03OtherBWC