Provider Demographics
NPI:1710920491
Name:MRI COOPERATIVE CO.
Entity Type:Organization
Organization Name:MRI COOPERATIVE CO.
Other - Org Name:FORUM HEALTH DIAGNOSTICS AUSTINTOWN IMAGING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:MCGUIRE
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:330-884-2150
Mailing Address - Street 1:6414 MARKET STREET
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-3457
Mailing Address - Country:US
Mailing Address - Phone:330-884-2150
Mailing Address - Fax:330-884-2152
Practice Address - Street 1:6414 MARKET STREET
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44512-3457
Practice Address - Country:US
Practice Address - Phone:330-884-2150
Practice Address - Fax:330-884-2152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0740032Medicaid
OHP00131578OtherRAILROAD MEDICARE
I000193Medicare ID - Type Unspecified
I0000191Medicare ID - Type Unspecified
OH0740032Medicaid