Healthcare Provider Details

I. General information

NPI: 1841064789
Provider Name (Legal Business Name): ALBUQUERQUE MRI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2023
Last Update Date: 05/30/2024
Certification Date: 05/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4630 JEFFERSON LN NE STE B
ALBUQUERQUE NM
87109-2117
US

IV. Provider business mailing address

4630 JEFFERSON LN NE STE B
ALBUQUERQUE NM
87109-2117
US

V. Phone/Fax

Practice location:
  • Phone: 505-361-1931
  • Fax:
Mailing address:
  • Phone: 505-361-1931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. PHILIP HUNTER JOCHEM
Title or Position: CEO
Credential:
Phone: 505-361-1931