Healthcare Provider Details

I. General information

NPI: 1427318757
Provider Name (Legal Business Name): PARKWAY RADIOLOGY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2012
Last Update Date: 02/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 WESTERN MARYLAND PARKWAY SUITE 105
HAGERSTOWN MD
21740
US

IV. Provider business mailing address

13 WESTERN MARYLAND PARKWAY SUITE 105
HAGERSTOWN MD
21740
US

V. Phone/Fax

Practice location:
  • Phone: 240-329-4642
  • Fax: 240-329-5299
Mailing address:
  • Phone: 240-329-4642
  • Fax: 240-329-5299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. ALLAN MERCER
Title or Position: OWNER
Credential:
Phone: 516-849-6200