Provider Demographics
NPI:1801281100
Name:ON-SITE IMAGING SOLUTIONS LLC
Entity type:Organization
Organization Name:ON-SITE IMAGING SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:
Authorized Official - Last Name:HUDSPETH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-889-8938
Mailing Address - Street 1:PO BOX 941551
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33194-1551
Mailing Address - Country:US
Mailing Address - Phone:678-889-8938
Mailing Address - Fax:877-398-4160
Practice Address - Street 1:10755 BRUNSON DR
Practice Address - Street 2:
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30097-8465
Practice Address - Country:US
Practice Address - Phone:678-889-8938
Practice Address - Fax:877-398-4160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-02
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
No247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistGroup - Single Specialty