Provider Demographics
NPI:1184248106
Name:ANYWHERE X-RAY LLC
Entity type:Organization
Organization Name:ANYWHERE X-RAY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNA
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:HUTCHINSON
Authorized Official - Suffix:
Authorized Official - Credentials:RT(R)
Authorized Official - Phone:912-222-0475
Mailing Address - Street 1:204 PALM CLUB CIR
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31525-2049
Mailing Address - Country:US
Mailing Address - Phone:912-222-0475
Mailing Address - Fax:
Practice Address - Street 1:204 PALM CLUB CIR
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31525-2049
Practice Address - Country:US
Practice Address - Phone:912-222-0475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-05
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile