Provider Demographics
NPI:1972156214
Name:HOOSIER MOBILE IMAGING INC.
Entity Type:Organization
Organization Name:HOOSIER MOBILE IMAGING INC.
Other - Org Name:LIFE SAVING IMAGES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:COCKERHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-626-1720
Mailing Address - Street 1:9292 N MERIDIAN ST STE 325
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-1857
Mailing Address - Country:US
Mailing Address - Phone:317-626-1720
Mailing Address - Fax:
Practice Address - Street 1:9292 N MERIDIAN ST STE 325
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-1857
Practice Address - Country:US
Practice Address - Phone:317-626-1720
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-16
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0207XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile Mammography