Provider Demographics
NPI:1396990222
Name:ION OF BETHESDA, LLC
Entity type:Organization
Organization Name:ION OF BETHESDA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-433-1717
Mailing Address - Street 1:6420 ROCKLEDGE DR
Mailing Address - Street 2:SUITE 4200
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-7837
Mailing Address - Country:US
Mailing Address - Phone:800-977-1513
Mailing Address - Fax:
Practice Address - Street 1:6420 ROCKLEDGE DR
Practice Address - Street 2:SUITE 4200
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-7837
Practice Address - Country:US
Practice Address - Phone:800-977-1513
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ION HEALTHCARE CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-11-19
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies