Provider Demographics
NPI:1649273566
Name:OPEN MRI OF COLUMBUS, L.L.C.
Entity type:Organization
Organization Name:OPEN MRI OF COLUMBUS, L.L.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BUCHWALTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-573-8080
Mailing Address - Street 1:100 PARAGON DR
Mailing Address - Street 2:STE 200
Mailing Address - City:MONTVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07645-1718
Mailing Address - Country:US
Mailing Address - Phone:201-573-8080
Mailing Address - Fax:201-775-4306
Practice Address - Street 1:6096 E MAIN ST
Practice Address - Street 2:STE 100
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-4302
Practice Address - Country:US
Practice Address - Phone:614-751-5000
Practice Address - Fax:614-751-0499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0837-IC261QR0200X, 261QM1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Not Answered261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1067796OtherFIRST HEALTH NETWORK
OH000000162279OtherANTHEM
OH175273OtherUNISON
OH2433558Medicaid
OH3364OtherMEDFOCUS
OH5688308OtherAETNA
OH=========-006OtherMEDICAL MUTUAL OF OH
OH=========-027OtherCARESOURCE
OH=========00OtherBWC