Provider Demographics
NPI:1285931881
Name:ONSITE ADVANCED IMAGING LLC
Entity type:Organization
Organization Name:ONSITE ADVANCED IMAGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:SAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-228-4553
Mailing Address - Street 1:PO BOX 61328
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31420-1328
Mailing Address - Country:US
Mailing Address - Phone:912-228-5469
Mailing Address - Fax:866-283-7925
Practice Address - Street 1:11551 SOUTHERN BLVD
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-4254
Practice Address - Country:US
Practice Address - Phone:561-228-4553
Practice Address - Fax:866-283-7925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-16
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
No261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile