Provider Demographics
NPI:1518382985
Name:PHYSICIAN'S MOBILE X-RAY, INC
Entity Type:Organization
Organization Name:PHYSICIAN'S MOBILE X-RAY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:GELBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-561-4940
Mailing Address - Street 1:6310 ALLENTOWN BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-2739
Mailing Address - Country:US
Mailing Address - Phone:717-561-4940
Mailing Address - Fax:717-561-4999
Practice Address - Street 1:3540 THREE LITTLE BAKERS BLVD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-1754
Practice Address - Country:US
Practice Address - Phone:717-561-4940
Practice Address - Fax:717-561-4999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-21
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA2085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Single Specialty