Provider Demographics
NPI:1760109243
Name:COMMUNITY OPEN MRI OF AUBURN, LLC
Entity Type:Organization
Organization Name:COMMUNITY OPEN MRI OF AUBURN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:PLATUSIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-363-1007
Mailing Address - Street 1:196 W SPOTSWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:VA
Mailing Address - Zip Code:22827-1169
Mailing Address - Country:US
Mailing Address - Phone:804-217-7114
Mailing Address - Fax:804-217-7120
Practice Address - Street 1:1850 E DUPONT RD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46825-1581
Practice Address - Country:US
Practice Address - Phone:260-422-1491
Practice Address - Fax:260-423-1421
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMUNITY OPEN MRI OF AUBURN, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-10-25
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty