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Bobodzhanov Inc
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Meridian, Idaho
NPI 1013081058

Bobodzhanov Inc is a Portable X-ray and/or Other Portable Diagnostic Imaging Supplier based in Meridian, ID. Bobodzhanov Inc practices in Meridian, ID. The NPI Number for Bobodzhanov Inc is 1013081058 and holds a License No. (Idaho).

The current practice location address for Bobodzhanov Inc is 440 W Broderick Dr, Meridian, ID and can be reached out via phone at 206-786-6936 and via fax at 206-621-4176.

Location: 440 W Broderick Dr, Meridian, ID, 83646-6427
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1013081058
Provider Name
Bobodzhanov Inc
Credential
Provider Entity Type
Organization
Address
440 W Broderick Dr, Meridian, ID, 83646-6427
Phone Number
206-786-6936
Fax Number
206-621-4176
Provider Enumeration Date
11/20/2006
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0185002 01 WA LABOR AND INDUSTRIES
7130BO 01 WA REGENCE
47001664 01 WA RAILROAD MEDICARE
7115389 05 WA
568397002 01 WA GROUP HEALTH COOPERATIVE
institution
Provider Business Practice Location Address Details
Address
440 W Broderick Dr
City
Meridian
State
Idaho
Zip
83646-6427
Phone Number
206-786-6936
Fax Number
206-621-4176
person
Provider Business Mailing Address Details
Address
440 W Broderick Dr
City
Meridian
State
Idaho
Zip
83646-6427
Phone Number
206-786-6936
Fax Number
206-621-4176
person
Provider's Taxonomy Details 1
Type
Technologists, Technicians & Other Technical Service Providers
Classification
Specialist/Technologist Cardiovascular
Speciality
Sonography
Taxonomy
246XS1301X
License No.
N/A PORTABLE U/S (Washington)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Technologists, Technicians & Other Technical Service Providers
Classification
Radiologic Technologist
Speciality
Sonography
Taxonomy
2471S1302X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Technologists, Technicians & Other Technical Service Providers
Classification
Radiologic Technologist
Speciality
Vascular Sonography
Taxonomy
2471V0105X
License No.
()
Definition
Definition to come.
person
Provider's Taxonomy Details 4
Type
Suppliers
Classification
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Speciality
-
Taxonomy
335V00000X
License No.
()
Definition
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.
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