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NPI Code Detail

MEDICARE: INMED DIAGNOSTIC SERVICES OF MASSACHUSETTS LLC

MEDICARE: INMED DIAGNOSTIC SERVICES OF MASSACHUSETTS 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
1261QR0206XMammography Clinic/Center236414MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1366569923
Entity Type Code : Organization
Provider Name (Legal Business Name) : INMED DIAGNOSTIC SERVICES OF MASSACHUSETTS LLC
Provider Business Mailing Address
First Line : 2400 E COMMERCIAL BLVD
Second Line : SUITE 826
City : FT LAUDERDALE
State : FL
Zip : 33308-4030
Country : US
Telephone Number : 954-510-3700
Fax Number : 954-510-2649
Provider Business Practice Location Address
First Line : 434 ROUTE 134
Second Line : UNIT C-2
City : SOUTH DENNIS
State : MA
Zip : 02660-3433
Country : US
Telephone Number : 508-398-3617
Fax Number : 508-398-3763
Authorized Official
Title or Position : COO
Name : ELIZABETH LONGTON
Credential :
Telephone Number : 954-510-3704
Provider Enumeration Date : 03/26/2007
Last Update Date : 10/31/2014

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Directions to “INMED DIAGNOSTIC SERVICES OF MASSACHUSETTS LLC ” Practice Location

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