Provider Demographics
NPI:1255710448
Name:PRECISION MEDICAL IMAGING, LLC
Entity type:Organization
Organization Name:PRECISION MEDICAL IMAGING, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/DIRECTOR OF OPERATION
Authorized Official - Prefix:MR
Authorized Official - First Name:DINO
Authorized Official - Middle Name:
Authorized Official - Last Name:MANNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:670-233-6000
Mailing Address - Street 1:PO BOX 10003, PMB 476
Mailing Address - Street 2:
Mailing Address - City:SAIPAN
Mailing Address - State:MP
Mailing Address - Zip Code:96950
Mailing Address - Country:US
Mailing Address - Phone:670-233-6000
Mailing Address - Fax:670-233-6004
Practice Address - Street 1:1 SPRINGS PLAZA #24, GUALO RAI, MIDDLE ROAD
Practice Address - Street 2:
Practice Address - City:SAIPAN
Practice Address - State:MP
Practice Address - Zip Code:96950
Practice Address - Country:US
Practice Address - Phone:670-233-6000
Practice Address - Fax:670-233-6004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-21
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MP19027-0001-32085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty