Provider Demographics
NPI:1801835889
Name:BERGER AND BURROW ENTERPRISES INC.
Entity Type:Organization
Organization Name:BERGER AND BURROW ENTERPRISES INC.
Other - Org Name:DYNAMIC MOBILE IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP-AO
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-589-4149
Mailing Address - Street 1:PO BOX 17588
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-7588
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6015 STAPLES MILL RD
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23228-4923
Practice Address - Country:US
Practice Address - Phone:866-483-9729
Practice Address - Fax:804-282-7303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-05
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
No293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010230403Medicaid
VA010230403Medicaid
MD374320Medicare PIN
DC188701Medicare PIN
DC244790Medicare PIN
VA499818Medicare PIN
MD333312Medicare PIN