Provider Demographics
NPI:1912206392
Name:SUPERIOR MOBILE IMAGING INC
Entity Type:Organization
Organization Name:SUPERIOR MOBILE IMAGING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RADIOLOGIC TECHNOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:EDDIE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:AYERS
Authorized Official - Suffix:
Authorized Official - Credentials:RT
Authorized Official - Phone:205-412-4931
Mailing Address - Street 1:1860 US HIGHWAY 43
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35594-5062
Mailing Address - Country:US
Mailing Address - Phone:205-412-4931
Mailing Address - Fax:205-487-1114
Practice Address - Street 1:1860 US HIGHWAY 43
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:AL
Practice Address - Zip Code:35594-5062
Practice Address - Country:US
Practice Address - Phone:205-412-4931
Practice Address - Fax:205-487-1114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-24
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6728121335V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier