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Contact Information

VIDALIA OPEN MRI, LLC
3165 E 1ST ST
VIDALIA, GA30474-8830
 Phone: 800-474-1077
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Magnetic Resonance Imaging Radiologic Technologist

2471M1202X
Indicates primary specialty

NPI Profile & details for VIDALIA OPEN MRI, LLC

NPI Number 1164599353
LBN Legal business name VIDALIA OPEN MRI, LLC
Authorized official FRANK HARRELSON - (OFFICE MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 11/30/2006
Last updated 08/17/2007 - About 19 years ago
Identifiers
GA License # 025199
GA Medicaid 000303751E
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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