Provider Demographics
NPI:1669724027
Name:SAINT MARY OPEN MRI & CT INC
Entity type:Organization
Organization Name:SAINT MARY OPEN MRI & CT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMJAD
Authorized Official - Middle Name:
Authorized Official - Last Name:SAFVI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-923-8540
Mailing Address - Street 1:8149 KENNEDY AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:HIGHLAND
Mailing Address - State:IN
Mailing Address - Zip Code:46322-1128
Mailing Address - Country:US
Mailing Address - Phone:219-923-8540
Mailing Address - Fax:219-923-6742
Practice Address - Street 1:8149 KENNEDY AVE
Practice Address - Street 2:SUITE A
Practice Address - City:HIGHLAND
Practice Address - State:IN
Practice Address - Zip Code:46322-1128
Practice Address - Country:US
Practice Address - Phone:219-923-8540
Practice Address - Fax:219-923-6742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-10
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistGroup - Multi-Specialty