Provider Demographics
NPI:1962489831
Name:MOBILE RADIOLOGY & EKG SERVICE, INC
Entity Type:Organization
Organization Name:MOBILE RADIOLOGY & EKG SERVICE, INC
Other - Org Name:RADS MOBILE X-RAY & EKG OR RADS MOBILE X-RAY & DIGITAL IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:W
Authorized Official - Last Name:CARTWRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-443-0389
Mailing Address - Street 1:PO BOX 17159
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33762-0159
Mailing Address - Country:US
Mailing Address - Phone:727-443-0389
Mailing Address - Fax:727-442-7851
Practice Address - Street 1:5405 NW 102ND AVE
Practice Address - Street 2:SUITE 243
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-8746
Practice Address - Country:US
Practice Address - Phone:954-578-8390
Practice Address - Fax:954-578-0624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC6550335V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherEVERCARE
FL=========OtherHUMANA
FL=========OtherEVERCARE