Fayetteville Mri, Llc

LBN: Fayetteville Mri, Llc
Fayetteville Mri, Llc is an health care organization with primary practice located at 106 Medical Center Blvd , Fayetteville TN 37334-2684. The organization recently has only one registered license in Ambulatory Health Care Facilities / Radiology, which is considered as the primary health care specialty. Fayetteville Mri, Llc can be contacted via phone (937) 438-7344, or through Gabriel, Mark B via phone (317) 634-2222.

Contact Information

Primary practice address
106 Medical Center Blvd Fayetteville TN 37334-2684
Phone: (937) 438-7344
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Gabriel, Mark B
Phone: (317) 634-2222

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Radiology 261QR0200X NA Indiana

Profile Details

NPI number 1710972419
LBN Legal business name Fayetteville Mri, Llc
DBA Doing business as
Authorized official Gabriel, Mark B
Entity Organization
Organization subpart 1 No
Enumeration date Sep 19th, 2005
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710972419 NPPES
Tennessee Other 1640521 UNITED HEALTHCARE
Tennessee MEDICAID 3790830 UNITED HEALTHCARE

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