Provider Demographics
NPI:1598074171
Name:UNITED MOBILE IMAGING INC
Entity Type:Organization
Organization Name:UNITED MOBILE IMAGING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:DARRYL
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:336-403-3152
Mailing Address - Street 1:1200 MAIN ST
Mailing Address - Street 2:SUITE M105
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-3234
Mailing Address - Country:US
Mailing Address - Phone:800-983-9840
Mailing Address - Fax:800-983-9841
Practice Address - Street 1:1200 MAIN ST
Practice Address - Street 2:SUITE M105
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-3234
Practice Address - Country:US
Practice Address - Phone:800-983-9840
Practice Address - Fax:800-983-9841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-30
Last Update Date:2010-09-30
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
SC498189Medicaid
SC498189Medicaid