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NPI Code Detail

MEDICARE: RADIOLOGICAL ASSOCIATES OF LOWELL, INC.

MEDICARE: RADIOLOGICAL ASSOCIATES OF LOWELL, INC.
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
12085R0202XDiagnostic Radiology Physician

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 : 1396792917
Entity Type Code : Organization
Provider Name (Legal Business Name) : RADIOLOGICAL ASSOCIATES OF LOWELL, INC.
Provider Business Mailing Address
First Line : 43 VILLAGE SQ
Second Line :
City : CHELMSFORD
State : MA
Zip : 01824-2726
Country : US
Telephone Number : 978-256-3553
Fax Number : 978-256-0161
Provider Business Practice Location Address
First Line : 43 VILLAGE SQ
Second Line :
City : CHELMSFORD
State : MA
Zip : 01824-2726
Country : US
Telephone Number : 978-256-3553
Fax Number : 978-256-0161
Authorized Official
Title or Position : PRESIDENT
Name : KENNETH R PEELLE
Credential : MD
Telephone Number : 978-256-3553
Provider Enumeration Date : 05/28/2006
Last Update Date : 08/22/2020

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