Healthcare Provider Details

I. General information

NPI: 1972722478
Provider Name (Legal Business Name): MOBILE IMAGING ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 03/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4901 LANG AVE NE
ALBUQUERQUE NM
87109-4397
US

IV. Provider business mailing address

4901 LANG AVE NE
ALBUQUERQUE NM
87109-4397
US

V. Phone/Fax

Practice location:
  • Phone: 505-440-0884
  • Fax: 505-881-1181
Mailing address:
  • Phone: 505-440-0884
  • Fax: 505-881-1181

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: DR. RICHARD ALLEN HAMMER
Title or Position: MEDICAL DIRECTOR SECRETARY
Credential: M.D.
Phone: 505-363-4788