Provider Demographics
NPI:1528026911
Name:OPEN MRI & IMAGING OF RICHMOND
Entity Type:Organization
Organization Name:OPEN MRI & IMAGING OF RICHMOND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCHAEFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-300-0101
Mailing Address - Street 1:PO BOX 931912
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31193-1912
Mailing Address - Country:US
Mailing Address - Phone:866-659-1211
Mailing Address - Fax:336-774-1751
Practice Address - Street 1:11525 MIDLOTHIAN TPKE
Practice Address - Street 2:SUITE 103 & 104
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-4763
Practice Address - Country:US
Practice Address - Phone:804-594-2550
Practice Address - Fax:804-594-3950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-03
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA440657OtherBCBS VA
VA350588800OtherDOL
VA004700899Medicaid
470001438OtherMEDICARE RR
470001438OtherMEDICARE RR