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NPI Code Detail

MEDICARE: PALMS WEST MRI, LLC

MEDICARE: PALMS WEST MRI, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR0200XRadiology Clinic/CenterHCC8896FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2V2507OTHERFLBCBS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1871584771
Entity Type Code : Organization
Provider Name (Legal Business Name) : PALMS WEST MRI, LLC
Provider Business Mailing Address
First Line : PO BOX 212738
Second Line :
City : ROYAL PALM BEACH
State : FL
Zip : 33421-2738
Country : US
Telephone Number : 561-766-1300
Fax Number : 561-318-7163
Provider Business Practice Location Address
First Line : 701 S MAIN ST
Second Line :
City : BELLE GLADE
State : FL
Zip : 33430-4201
Country : US
Telephone Number : 561-996-2000
Fax Number : 561-996-2008
Authorized Official
Title or Position : OWNER
Name : ARTHUR HANSEN
Credential :
Telephone Number : 561-766-1300
Provider Enumeration Date : 10/31/2005
Last Update Date : 10/01/2014

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