Provider Demographics
NPI:1902091341
Name:RAMIC OKLAHOMA CITY, LLC
Entity Type:Organization
Organization Name:RAMIC OKLAHOMA CITY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:ISCH
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:405-749-0074
Mailing Address - Street 1:9654 N MAY AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-2714
Mailing Address - Country:US
Mailing Address - Phone:405-749-0074
Mailing Address - Fax:405-749-0062
Practice Address - Street 1:9654 N MAY AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-2714
Practice Address - Country:US
Practice Address - Phone:405-749-0074
Practice Address - Fax:405-749-0062
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GENESIS MEDICAL IMAGING, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-09-10
Last Update Date:2011-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKOKB5378Medicare PIN