Basic Information
| Provider Information | |||||||||
| NPI: | 1861864829 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | OHIO MEDICAL IMAGING JV LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 BAYVIEW CIR STE 400 | ||||||||
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| City: | NEWPORT BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926602984 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9492425592 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9371 E MARKET ST | ||||||||
| Address2: | |||||||||
| City: | WARREN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 444845551 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8005443215 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/29/2015 | ||||||||
| LastUpdateDate: | 10/21/2016 | ||||||||
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| AuthorizedOfficialLastName: | LONGMORE-GRUND | ||||||||
| AuthorizedOfficialFirstName: | RHONDA | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXEC VP &CFO | ||||||||
| AuthorizedOfficialTelephone: | 8005443215 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0200X | Y | Ambulatory Health Care Facilities | Clinic/Center | Radiology |
No ID Information.