Provider Demographics
NPI:1861836835
Name:CAMELOT IMAGING SOLUTIONS, LTD
Entity Type:Organization
Organization Name:CAMELOT IMAGING SOLUTIONS, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:M
Authorized Official - Last Name:STEMM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-397-5554
Mailing Address - Street 1:129 PHELPS AVE
Mailing Address - Street 2:SUITE 213
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61108-2453
Mailing Address - Country:US
Mailing Address - Phone:815-397-5554
Mailing Address - Fax:866-914-7594
Practice Address - Street 1:129 PHELPS AVE
Practice Address - Street 2:SUITE 213
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61108-2453
Practice Address - Country:US
Practice Address - Phone:815-397-5554
Practice Address - Fax:866-914-7594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-22
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier