Provider Demographics
NPI:1629618558
Name:REMOTE ACCESS DIAGNOSTIC SERVICES
Entity Type:Organization
Organization Name:REMOTE ACCESS DIAGNOSTIC SERVICES
Other - Org Name:MARYIMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMANUEL
Authorized Official - Middle Name:BERHANE
Authorized Official - Last Name:HAILE
Authorized Official - Suffix:
Authorized Official - Credentials:RT(R)(MR)
Authorized Official - Phone:720-339-1029
Mailing Address - Street 1:14221 E 4TH AVE STE 2-221
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-8735
Mailing Address - Country:US
Mailing Address - Phone:720-639-4410
Mailing Address - Fax:855-373-2943
Practice Address - Street 1:14221 E 4TH AVE STE 2-221
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-8735
Practice Address - Country:US
Practice Address - Phone:720-639-4410
Practice Address - Fax:855-373-2943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-08
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile