Provider Demographics
NPI:1508849431
Name:OHIO MOBILE X-RAY INC
Entity Type:Organization
Organization Name:OHIO MOBILE X-RAY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V. PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MUNEER
Authorized Official - Middle Name:
Authorized Official - Last Name:HASAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-544-1249
Mailing Address - Street 1:5525 SCHULTZ DR
Mailing Address - Street 2:STE B
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-2383
Mailing Address - Country:US
Mailing Address - Phone:440-942-1110
Mailing Address - Fax:440-942-0608
Practice Address - Street 1:5525 SCHULTZ DR
Practice Address - Street 2:STE B
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-2383
Practice Address - Country:US
Practice Address - Phone:440-942-1110
Practice Address - Fax:440-942-0608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-23
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0208493Medicaid
OH0208493Medicaid
OH3698471Medicare PIN