Provider Demographics
NPI:1508213554
Name:TOTAL MEDICAL IMAGING
Entity Type:Organization
Organization Name:TOTAL MEDICAL IMAGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:RUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-596-5328
Mailing Address - Street 1:40 E MAIN ST
Mailing Address - Street 2:SUITE #720
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-4639
Mailing Address - Country:US
Mailing Address - Phone:678-596-5328
Mailing Address - Fax:
Practice Address - Street 1:40 E MAIN ST
Practice Address - Street 2:SUITE #720
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-4639
Practice Address - Country:US
Practice Address - Phone:678-596-5328
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-19
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE2016603668174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty