Provider Demographics
NPI:1619453891
Name:WASHINGTON OPEN MRI INC
Entity Type:Organization
Organization Name:WASHINGTON OPEN MRI INC
Other - Org Name:WASHINGTON OPEN MRI - OXON HILL
Other - Org Type:Other Name
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ALYSON
Authorized Official - Middle Name:
Authorized Official - Last Name:MOST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-424-4888
Mailing Address - Street 1:15005 SHADY GROVE RD STE 110
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-6341
Mailing Address - Country:US
Mailing Address - Phone:301-567-0986
Mailing Address - Fax:
Practice Address - Street 1:6196 OXON HILL RD STE 110
Practice Address - Street 2:
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-3138
Practice Address - Country:US
Practice Address - Phone:301-567-0986
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WASHINGTON OPEN MRI INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-07-11
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDM373261Q00000X, 261QM1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC472315OtherMEDICARE