Provider Demographics
NPI:1780639559
Name:M. R. IMAGING SYSTEMS, INC.
Entity Type:Organization
Organization Name:M. R. IMAGING SYSTEMS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:O
Authorized Official - Last Name:GREMILLION
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-443-7674
Mailing Address - Street 1:211 N 3RD ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-8584
Mailing Address - Country:US
Mailing Address - Phone:318-443-7674
Mailing Address - Fax:318-443-4102
Practice Address - Street 1:211 N 3RD ST
Practice Address - Street 2:SUITE B
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-8584
Practice Address - Country:US
Practice Address - Phone:318-443-7674
Practice Address - Fax:318-443-4102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1441406Medicaid
LA5C691Medicare ID - Type Unspecified