Provider Demographics
NPI:1669417911
Name:COMPUTERIZED MEDICAL IMAGING INC.
Entity type:Organization
Organization Name:COMPUTERIZED MEDICAL IMAGING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:STANGL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-839-8020
Mailing Address - Street 1:PO BOX 1426
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54702-1426
Mailing Address - Country:US
Mailing Address - Phone:715-838-8898
Mailing Address - Fax:715-838-8895
Practice Address - Street 1:719 W HAMILTON AVE
Practice Address - Street 2:STE B
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-6968
Practice Address - Country:US
Practice Address - Phone:715-839-8020
Practice Address - Fax:715-839-7440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2471B0102X, 2471C3402X, 2471M2300X, 2471N0900X, 2471S1302X, 247100000X
WI2471M1202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistGroup - Multi-Specialty
No2471B0102XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistBone DensitometryGroup - Multi-Specialty
No2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiographyGroup - Multi-Specialty
No2471M2300XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMammographyGroup - Multi-Specialty
No2471N0900XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistNuclear Medicine TechnologyGroup - Multi-Specialty
No2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Multi-Specialty
No2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance ImagingGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32807600Medicaid
WI92001Medicare ID - Type Unspecified