Provider Demographics
NPI:1063952166
Name:ON-DEMAND SCANNING LLC
Entity type:Organization
Organization Name:ON-DEMAND SCANNING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VIOREL
Authorized Official - Middle Name:
Authorized Official - Last Name:CODREANU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-703-4838
Mailing Address - Street 1:171 BLANCHE DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098-2934
Mailing Address - Country:US
Mailing Address - Phone:248-703-4838
Mailing Address - Fax:
Practice Address - Street 1:171 BLANCHE DR
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48098-2934
Practice Address - Country:US
Practice Address - Phone:248-703-4838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ON-DEMAND SCANNING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-03-08
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI00080829261QH0100X
MI164498261QR0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIE82467OtherDEPARTMENT OF LICENSING AND REGULATORY AFFAIRS