Provider Demographics
NPI:1689969172
Name:H & J MOBILE X-RAY LLC.
Entity Type:Organization
Organization Name:H & J MOBILE X-RAY LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HORACE
Authorized Official - Middle Name:ASHWORTH STEVENSON
Authorized Official - Last Name:MCCAMMON
Authorized Official - Suffix:
Authorized Official - Credentials:RT(R)
Authorized Official - Phone:301-613-0075
Mailing Address - Street 1:16109 ARROWROOT CT
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-3840
Mailing Address - Country:US
Mailing Address - Phone:301-613-0075
Mailing Address - Fax:
Practice Address - Street 1:6188 OXON HILL RD
Practice Address - Street 2:603
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-3113
Practice Address - Country:US
Practice Address - Phone:301-567-7300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-13
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1043771261QR0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile