Provider Demographics
NPI:1669568929
Name:PENNSYLVANIA OPEN MRI OF HARRISBURG, INC.
Entity type:Organization
Organization Name:PENNSYLVANIA OPEN MRI OF HARRISBURG, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:BLASCHAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-558-8300
Mailing Address - Street 1:5400 CHAMBERS HILL RD STE D
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-2547
Mailing Address - Country:US
Mailing Address - Phone:717-558-8300
Mailing Address - Fax:717-561-8024
Practice Address - Street 1:5400 CHAMBERS HILL RD STE D
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17111-2547
Practice Address - Country:US
Practice Address - Phone:717-558-8300
Practice Address - Fax:717-561-8024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD032855E2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty