Healthcare Provider Details
I. General information
NPI: 1750828539
Provider Name (Legal Business Name): SHIELDS IMAGING AT YORK HOSPITAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/31/2017
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
114 SANFORD RD
WELLS ME
04090-5533
US
IV. Provider business mailing address
700 CONGRESS ST STE 204
QUINCY MA
02169-0928
US
V. Phone/Fax
- Phone: 866-258-4738
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0208X |
| Taxonomy | Mobile Radiology Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KRISTEN
DELMORE
Title or Position: CFO
Credential:
Phone: 617-376-7400