Provider Demographics
NPI:1366752487
Name:UNITED MOBILE IMAGING INC
Entity type:Organization
Organization Name:UNITED MOBILE IMAGING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:DARRYL
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:336-403-3152
Mailing Address - Street 1:2554 LEWISVILLE CLEMMONS RD
Mailing Address - Street 2:SUITE 201 BOX 11
Mailing Address - City:CLEMMONS
Mailing Address - State:NC
Mailing Address - Zip Code:27012-8110
Mailing Address - Country:US
Mailing Address - Phone:800-983-9840
Mailing Address - Fax:800-983-9841
Practice Address - Street 1:2554 LEWISVILLE CLEMMONS RD
Practice Address - Street 2:SUITE 201 BOX 11
Practice Address - City:CLEMMONS
Practice Address - State:NC
Practice Address - Zip Code:27012-8110
Practice Address - Country:US
Practice Address - Phone:800-983-9840
Practice Address - Fax:800-983-9841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-08
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3409809Medicaid
NC2880622Medicare PIN