Provider Demographics
NPI:1689000580
Name:AMERICAN MOBILE X-RAY, LLC
Entity Type:Organization
Organization Name:AMERICAN MOBILE X-RAY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BETTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-741-1600
Mailing Address - Street 1:6802 MENZ LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45233-4311
Mailing Address - Country:US
Mailing Address - Phone:513-741-1600
Mailing Address - Fax:
Practice Address - Street 1:6802 MENZ LN
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45233-4311
Practice Address - Country:US
Practice Address - Phone:513-741-1600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-24
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory