Healthcare Provider Details

I. General information

NPI: 1134307408
Provider Name (Legal Business Name): PREMIER DIAGNOSTIC SERVICES INC 2
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2008
Last Update Date: 08/11/2022
Certification Date: 08/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

378 PAGE ST STE 410
STOUGHTON MA
02072-1124
US

IV. Provider business mailing address

378 PAGE ST STE 410
STOUGHTON MA
02072-1124
US

V. Phone/Fax

Practice location:
  • Phone: 508-584-5600
  • Fax: 508-584-6362
Mailing address:
  • Phone: 508-584-5600
  • Fax: 508-584-6362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2471V0105X
TaxonomyVascular Sonography Radiologic Technologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code246W00000X
TaxonomyCardiology Technician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code246XS1301X
TaxonomySonography Specialist/Technologist Cardiovascular
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code246ZE0500X
TaxonomyEEG Specialist/Technologist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2471B0102X
TaxonomyBone Densitometry Radiologic Technologist
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIAM MCCURDY
Title or Position: PRESIDENT / OWNER
Credential:
Phone: 508-584-5600