Provider Demographics
NPI:1649416140
Name:1ST MOBILE ULTRASOUND SERVICES LLC
Entity Type:Organization
Organization Name:1ST MOBILE ULTRASOUND SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V.P. OF OPERATION
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:BESTERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-434-6021
Mailing Address - Street 1:20671 E DARTMOUTH DR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80013-8441
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20671 E DARTMOUTH DR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80013-8441
Practice Address - Country:US
Practice Address - Phone:720-434-6021
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-05
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier