Provider Demographics
NPI:1316984719
Name:OPENSIDED MRI OF CLEVELAND, LLC
Entity type:Organization
Organization Name:OPENSIDED MRI OF CLEVELAND, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:RHODES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-217-7114
Mailing Address - Street 1:30400 DETROIT RD
Mailing Address - Street 2:SUITE 30
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145
Mailing Address - Country:US
Mailing Address - Phone:888-808-6736
Mailing Address - Fax:440-808-0289
Practice Address - Street 1:30400 DETROIT RD
Practice Address - Street 2:SUITE 30
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145
Practice Address - Country:US
Practice Address - Phone:888-808-6736
Practice Address - Fax:440-808-0289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance ImagingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2368745Medicaid
OH2368745Medicaid