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General NPI Number Information
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NPI Number | 1639111958
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Entity Type | Organization
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Legal Business Name | WESTERN MASSACHUSETTS MAGNETIC RESONANCE SERVICES LLC
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Dates
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Enumeration Date | 06/12/2006
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Last Update Date | 12/30/2019
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Provider Practice Location Address
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Address Line | 2033 MAIN ST
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City | ATHOL
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State | MA
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Zip | 01331-3535
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Country | US
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Telephone | 978-249-3511
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Fax |
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Provider Business Mailing Address
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Address Line | 18201 VON KARMAN AVE STE 600
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City | IRVINE
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State | CA
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Zip | 92612-1176
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Country | US
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Telephone | 800-544-3215
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | WILLIAM LARKIN
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Credential |
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Telephone | 800-544-3215
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number | 4380
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License Number State | MA
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