Provider Demographics
NPI:1366425571
Name:OPEN MRI OF NORTH WEST FLORIDA, LLC
Entity type:Organization
Organization Name:OPEN MRI OF NORTH WEST FLORIDA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:L
Authorized Official - Last Name:MCCRAY
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:850-434-6674
Mailing Address - Street 1:997 S PALAFOX ST
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32502-5939
Mailing Address - Country:US
Mailing Address - Phone:850-434-6674
Mailing Address - Fax:850-434-9664
Practice Address - Street 1:997 S PALAFOX ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32502-5939
Practice Address - Country:US
Practice Address - Phone:850-434-6674
Practice Address - Fax:850-434-9664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-22
Last Update Date:2020-08-22
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
FLV3021OtherBCBS OF FL
FLV3021OtherBCBS OF FL
FLV3021OtherBCBS OF FL
FLP00241365Medicare ID - Type UnspecifiedRAILROAD MEDICARE