Provider Demographics
NPI:1770550550
Name:OPEN MRI, LLC
Entity type:Organization
Organization Name:OPEN MRI, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ROTHSCHILD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-429-6500
Mailing Address - Street 1:PO BOX 950131
Mailing Address - Street 2:DEPT 52629
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0131
Mailing Address - Country:US
Mailing Address - Phone:502-429-6500
Mailing Address - Fax:502-429-0770
Practice Address - Street 1:5227 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40216-1758
Practice Address - Country:US
Practice Address - Phone:502-429-6500
Practice Address - Fax:502-429-0770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-01
Last Update Date:2015-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody ImagingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100067880Medicaid
IN201005330AMedicaid
DG2361OtherMEDICARE RAILROAD
IN201005330AMedicaid
DG2361OtherMEDICARE RAILROAD
KY7100067880Medicaid
ININ1466Medicare PIN
OHH260570Medicare PIN