1275801631 NPI number — MRI CONSULTANTS LEWES

Table of content: (NPI 1275801631)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275801631 NPI number — MRI CONSULTANTS LEWES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MRI CONSULTANTS LEWES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275801631
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/13/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
17252 N VILLAGE MAIN BLVD STE 9
Provider Second Line Business Mailing Address:
FIVE POINTS SHOPPING CENTER
Provider Business Mailing Address City Name:
LEWES
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19958-6292
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
302-566-8600
Provider Business Mailing Address Fax Number:
888-677-7145

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 CENTURIAN DR STE 107
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWARK
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19713-2154
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-295-3367
Provider Business Practice Location Address Fax Number:
302-999-9897
Provider Enumeration Date:
12/13/2011

Additional Information

Authorized Official

Authorized Official Last Name:
CHAO
Authorized Official First Name:
PHILIP
Authorized Official Middle Name:
W
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
302-566-6600

Provider Taxonomy Codes

  • Taxonomy code: 261QM1200X , with the licence number:  C1-0003457 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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