Provider Demographics
NPI:1891712311
Name:ROCKVILLE OPEN MRI, INC.
Entity Type:Organization
Organization Name:ROCKVILLE OPEN MRI, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MOLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-435-6674
Mailing Address - Street 1:15200 SHADY GROVE RD
Mailing Address - Street 2:SUITE #101
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3218
Mailing Address - Country:US
Mailing Address - Phone:301-947-0700
Mailing Address - Fax:301-947-0701
Practice Address - Street 1:15200 SHADY GROVE RD
Practice Address - Street 2:SUITE #101
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3218
Practice Address - Country:US
Practice Address - Phone:301-947-0700
Practice Address - Fax:301-947-0701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDM262261QM1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCFMX010Medicare ID - Type Unspecified