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General NPI Number Information
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NPI Number | 1730122508
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Entity Type | Organization
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Legal Business Name | NEW ENGLAND MOLECULAR IMAGING LLC
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 10/19/2016
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Provider Practice Location Address
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Address Line | 15 HOSPITAL DR
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City | YORK
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State | ME
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Zip | 03909-1011
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Country | US
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Telephone | 207-363-4321
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Fax |
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Provider Business Mailing Address
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Address Line | 100 BAYVIEW CIRCLE SUITE 400
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-2984
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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 | EXEC VP & CFO
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Name | RHONDA LONGMORE GRUND
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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 | 01601
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License Number State | ME
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