Provider Demographics
NPI:1861482911
Name:PROSCAN OPEN MRI EAST, LTD.
Entity Type:Organization
Organization Name:PROSCAN OPEN MRI EAST, LTD.
Other - Org Name:PROSCAN IMAGING EASTGATE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. DIR. CORP. ADMIN.
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:E
Authorized Official - Last Name:AMAYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-924-5174
Mailing Address - Street 1:4440 GLEN ESTE WITHAMSVILLE RD
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45245-1318
Mailing Address - Country:US
Mailing Address - Phone:513-947-9801
Mailing Address - Fax:513-947-8911
Practice Address - Street 1:4440 GLEN ESTE WITHAMSVILLE RD
Practice Address - Street 2:SUITE 1100
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45245-1318
Practice Address - Country:US
Practice Address - Phone:513-281-3400
Practice Address - Fax:513-527-2275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-28
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH470001875OtherRAILROAD MEDICARE
KY86000502Medicaid
OH2141257Medicaid
OHID00291Medicare PIN