Provider Demographics
NPI:1457357501
Name:OPENSIDED MRI OF NEW ORLEANS, LLC
Entity Type:Organization
Organization Name:OPENSIDED MRI OF NEW ORLEANS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:RHODES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-217-7114
Mailing Address - Street 1:1 GALLERIA BLVD
Mailing Address - Street 2:STE 715
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-7512
Mailing Address - Country:US
Mailing Address - Phone:888-749-6736
Mailing Address - Fax:504-837-0835
Practice Address - Street 1:1 GALLERIA BLVD
Practice Address - Street 2:STE 715
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-7512
Practice Address - Country:US
Practice Address - Phone:504-837-6736
Practice Address - Fax:504-837-0835
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-23
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2471M1202X
LA454551261QM1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
No2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance ImagingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1949027Medicaid
LA1949027Medicaid
LACN8696Medicare PIN