Provider Demographics
NPI:1891972147
Name:DIRECT MOBILE IMAGING, INC.
Entity Type:Organization
Organization Name:DIRECT MOBILE IMAGING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:HURST
Authorized Official - Suffix:
Authorized Official - Credentials:RDCS, RVT, EMTP
Authorized Official - Phone:940-427-2247
Mailing Address - Street 1:702 DECATUR ST
Mailing Address - Street 2:
Mailing Address - City:ALVORD
Mailing Address - State:TX
Mailing Address - Zip Code:76225-5085
Mailing Address - Country:US
Mailing Address - Phone:940-577-2230
Mailing Address - Fax:940-427-2749
Practice Address - Street 1:702 DECATUR ST
Practice Address - Street 2:
Practice Address - City:ALVORD
Practice Address - State:TX
Practice Address - Zip Code:76225-5085
Practice Address - Country:US
Practice Address - Phone:940-427-2247
Practice Address - Fax:940-427-2749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier