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DWAYNE R COOK HERITAGE MOBILE X-RAY NPI 1588838817


NPI Information

NPI: 1588838817
Provider Name: DWAYNE R COOK HERITAGE MOBILE X-RAY
Classification: Portable X-ray and/or Other Portable Diagnostic Imaging Supplier - 335V00000X
Entity Type: Organization
Address:
6330 N CENTER DR
SUITE 107
NORFOLK, VA
ZIP 23502
Phone: (757) 466-1163
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DWAYNE R COOK HERITAGE MOBILE X-RAY is a portable x ray and or other portable diagnostic imaging supplier in Norfolk, VA. The provider is a supplier that provides one or more of the following portable services, including but not limited to, x-ray, electrocardiogram (EKG), long-term EKG (Holter Monitor), bone densitometry, sonography, and other imaging services in accordance with all state and federal requirements, under the general supervision of a qualified physician. All necessary resources are transported to the patient's location where the services are performed. DWAYNE R COOK HERITAGE MOBILE X-RAY NPI is 1588838817. The provider is registered as an organization entity type.

The provider's business location address is:

6330 N CENTER DR
SUITE 107
NORFOLK, VA
ZIP 23502-008
Phone: (757) 466-1163
Fax: (757) 466-1178

The provider's authorized official is Dwayne Robert Cook .
The authorized official title is Owner and has the following contact phone number (757) 580-6040.

The enumeration date for this NPI number is 4/17/2008 and was last updated on 5/31/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1335V00000XPortable X-ray and/or Other Portable Diagnostic Imaging Supplier0120 002367VIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1630000023MEDICARE PINVIRGINIA
2008946752MEDICAIDVIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.