Provider Demographics
NPI:1932281896
Name:TENDER CARE MOBILE X-RAY COMP., INC
Entity Type:Organization
Organization Name:TENDER CARE MOBILE X-RAY COMP., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER OPERATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORITA
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:DILLON
Authorized Official - Suffix:
Authorized Official - Credentials:BS RT (R)
Authorized Official - Phone:765-294-2585
Mailing Address - Street 1:1278 E DIVISION RD
Mailing Address - Street 2:
Mailing Address - City:VEEDERSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47987-8307
Mailing Address - Country:US
Mailing Address - Phone:765-294-2585
Mailing Address - Fax:765-273-5400
Practice Address - Street 1:1278 E DIVISION RD
Practice Address - Street 2:
Practice Address - City:VEEDERSBURG
Practice Address - State:IN
Practice Address - Zip Code:47987-8307
Practice Address - Country:US
Practice Address - Phone:765-294-2585
Practice Address - Fax:765-273-5400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN3356332471C3402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiographyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200402170AMedicaid
IN1932281896Medicare PIN