Provider Demographics
NPI:1104248467
Name:MOBILE X RAY EXPRESS, LLC
Entity type:Organization
Organization Name:MOBILE X RAY EXPRESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:HANKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-545-9729
Mailing Address - Street 1:1020 TOWNSHIP ROAD 145
Mailing Address - Street 2:
Mailing Address - City:IRONTON
Mailing Address - State:OH
Mailing Address - Zip Code:45638-8593
Mailing Address - Country:US
Mailing Address - Phone:855-545-9729
Mailing Address - Fax:855-645-9729
Practice Address - Street 1:1020 TOWNSHIP ROAD 145
Practice Address - Street 2:
Practice Address - City:IRONTON
Practice Address - State:OH
Practice Address - Zip Code:45638-8593
Practice Address - Country:US
Practice Address - Phone:855-545-9729
Practice Address - Fax:855-645-9729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-06
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty