Provider Demographics
NPI:1871535161
Name:MOBILE ECHO AND IMAGING, INC.
Entity type:Organization
Organization Name:MOBILE ECHO AND IMAGING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:D
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:RT (R)(CV)
Authorized Official - Phone:419-468-6023
Mailing Address - Street 1:410 GRANT ST
Mailing Address - Street 2:
Mailing Address - City:GALION
Mailing Address - State:OH
Mailing Address - Zip Code:44833-1843
Mailing Address - Country:US
Mailing Address - Phone:419-468-6023
Mailing Address - Fax:419-468-9398
Practice Address - Street 1:410 GRANT ST
Practice Address - Street 2:
Practice Address - City:GALION
Practice Address - State:OH
Practice Address - Zip Code:44833-1843
Practice Address - Country:US
Practice Address - Phone:419-468-6023
Practice Address - Fax:419-468-9398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2460760Medicaid
OH2460760Medicaid