Provider Demographics
NPI:1710907316
Name:PRECISION IMAGING LLC
Entity Type:Organization
Organization Name:PRECISION IMAGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:WILLIAMSON
Authorized Official - Last Name:FAIRBANKS
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:301-656-7225
Mailing Address - Street 1:6000 EXECUTIVE BLVD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3803
Mailing Address - Country:US
Mailing Address - Phone:301-656-7226
Mailing Address - Fax:301-656-7225
Practice Address - Street 1:6000 EXECUTIVE BLVD
Practice Address - Street 2:SUITE 302
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3803
Practice Address - Country:US
Practice Address - Phone:301-656-7226
Practice Address - Fax:301-656-7225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCJ245OtherBCBS DC
DC020897500Medicaid
MD1295755429OtherDR. ROBERTO F. SOTO NPI
MD2118991OtherMAMSI ( ALL) - PET
MD4118991OtherMAMSI (ALL) RAD SRV
MD7185454OtherAETNA PPO
MDKFD9PROtherBSBS MD
MD403570400Medicaid
MD491644OtherNCPPO
613109700OtherDOL FECA
MD9138029OtherCIGNA
MD3118991OtherMAMSI ( ALL) - MRI
MD3245529OtherAETNA HMO
MDP00209099OtherMEDICARE RAILROAD
MD=========OtherCHAMP VA
MDKFD9PROtherBSBS MD
MD=========OtherJOHN HOPKINS
DC020897500Medicaid
MD9138029OtherCIGNA
DC020897500Medicaid
DCFDA009Medicare PIN
DCFMN005Medicare PIN