Provider Demographics
NPI:1508869397
Name:OPEN MRI OF MISSOURI II LLC
Entity Type:Organization
Organization Name:OPEN MRI OF MISSOURI II LLC
Other - Org Name:NYDIC OPEN MRI OF AMERICA-INDEPENDENCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BUCHWALTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-573-8080
Mailing Address - Street 1:100 PARAGON DR
Mailing Address - Street 2:STE 200
Mailing Address - City:MONTVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07645-1718
Mailing Address - Country:US
Mailing Address - Phone:201-573-8080
Mailing Address - Fax:201-505-8905
Practice Address - Street 1:3431 S HWY 291
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64057-2341
Practice Address - Country:US
Practice Address - Phone:816-795-6266
Practice Address - Fax:816-795-6966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
Not Answered261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO428178OtherHEALTHLINK
MO11720OtherHEALTHCARE USA
MO2042557OtherAETNA HMO
MO24822013OtherBCBS OF KANSAS CITY
MO16-00435OtherUNITED HC OF THE MIDWEST
MO1151126OtherFIRST HEALTH NETWORK
MO742299OtherCOVENTRY HC OF KANSAS
MO3987OtherFIRSTGUARD HEALTH PLAN
MO402227OtherBCBS OF KANSAS
MO5057623OtherAETNA PPOS
MO17065OtherMEDFOCUS
MO17065OtherMEDFOCUS
MO5057623OtherAETNA PPOS