Provider Demographics
NPI:1629133772
Name:TAYLOR STATION MRI, LLC
Entity Type:Organization
Organization Name:TAYLOR STATION MRI, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DALE
Authorized Official - Middle Name:
Authorized Official - Last Name:INGRAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-545-7900
Mailing Address - Street 1:255 TAYLOR STATION RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-4418
Mailing Address - Country:US
Mailing Address - Phone:614-575-8901
Mailing Address - Fax:614-575-8909
Practice Address - Street 1:255 TAYLOR STATION RD
Practice Address - Street 2:SUITE 100
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-4418
Practice Address - Country:US
Practice Address - Phone:614-575-8901
Practice Address - Fax:614-575-8909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance ImagingGroup - Single Specialty