MEDICARE: WINCHESTER HOSPITAL - SHIELDS MRI LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM1200X	Magnetic Resonance Imaging (MRI) Clinic/Center

General Provider Information

NPI Number	:	1134764186
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WINCHESTER HOSPITAL - SHIELDS MRI LLC

Provider Business Mailing Address
First Line	:	700 CONGRESS ST STE 204
Second Line	:
City	:	QUINCY
State	:	MA
Zip	:	02169-0928
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	41 HIGHLAND AVE STE G1
Second Line	:
City	:	WINCHESTER
State	:	MA
Zip	:	01890-1446
Country	:	US
Telephone Number	:	800-258-4679
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	KRISTEN DELMORE
Credential	:
Telephone Number	:	617-376-7400

Provider Enumeration Date	:	11/14/2019
Last Update Date	:	03/19/2026

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