Provider Demographics
NPI:1518358191
Name:SYMPHONY DIAGNOSTIC SERVICES NO 1 LLC
Entity Type:Organization
Organization Name:SYMPHONY DIAGNOSTIC SERVICES NO 1 LLC
Other - Org Name:MOBILEXUSA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:M
Authorized Official - Last Name:AMEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-786-8015
Mailing Address - Street 1:930 RIDGEBROOK RD
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:SPARKS
Mailing Address - State:MD
Mailing Address - Zip Code:21152-9390
Mailing Address - Country:US
Mailing Address - Phone:800-786-8015
Mailing Address - Fax:443-662-4230
Practice Address - Street 1:4113 BARDSTOWN RD
Practice Address - Street 2:STE 103
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-3293
Practice Address - Country:US
Practice Address - Phone:502-495-1848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-18
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier