Provider Demographics
NPI:1639122781
Name:E PLUS PET IMAGING X LP
Entity Type:Organization
Organization Name:E PLUS PET IMAGING X LP
Other - Org Name:PET IMAGING OF WHEAT RIDGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO OF GENERAL PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:RHYMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-467-7415
Mailing Address - Street 1:8550 W 38TH AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-4300
Mailing Address - Country:US
Mailing Address - Phone:720-407-0444
Mailing Address - Fax:720-407-0446
Practice Address - Street 1:8550 W 38TH AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-4300
Practice Address - Country:US
Practice Address - Phone:720-407-0444
Practice Address - Fax:720-407-0446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO60087765Medicaid
P00179372OtherRRMEDICARE
CO670772OtherBLUE CROSS/BLUE SHIELD
P00179372OtherRRMEDICARE