1306869581 NPI number — RADIOLOGY ASSOCIATES OF NORWOOD INC.

Table of content: (NPI 1306869581)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306869581 NPI number — RADIOLOGY ASSOCIATES OF NORWOOD INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RADIOLOGY ASSOCIATES OF NORWOOD INC.
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:
WOMENS IMAGING CENTER
Provider Other Organization Name Type Code:
3
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:
1306869581
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/18/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 688
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORWOOD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02062-0688
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
781-762-8010
Provider Business Mailing Address Fax Number:
781-762-7753

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
825 WASHINGTON ST
Provider Second Line Business Practice Location Address:
SUITE 215
Provider Business Practice Location Address City Name:
NORWOOD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02062-3441
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-762-5595
Provider Business Practice Location Address Fax Number:
781-762-9966
Provider Enumeration Date:
07/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
INTERRANTE
Authorized Official First Name:
ALBERT
Authorized Official Middle Name:
L
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
781-762-8010

Provider Taxonomy Codes

  • Taxonomy code: 2085N0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2085U0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 800206 . This is a "TUFTS HEALTHPLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: M10836 . This is a "ALL EXCEPT MRI" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1540432 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 033669 . This is a "MRI" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 9704078 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 600028 . This is a "HARVARDPILGRIM HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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