1598707093 NPI number — GREATER SPRINGFIELD MRI LIMITED PARTNERSHIP

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598707093 NPI number — GREATER SPRINGFIELD MRI LIMITED PARTNERSHIP

Employer Identification Number (EIN):

Provider Organization Name:

GREATER SPRINGFIELD MRI LIMITED PARTNERSHIP

Provider Last Name:

Provider First Name:

Provider Middle Name:

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NPI Number:

1598707093

Entity Type Code:

Organization

Replacement NPI:

Last Update Date:

07/24/2023

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

8300 W SUNRISE BLVD

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

PLANTATION

Provider Business Mailing Address State Name:

FL

Provider Business Mailing Address Postal Code:

33322-5406

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

271 CAREW ST

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

SPRINGFIELD

Provider Business Practice Location Address State Name:

MA

Provider Business Practice Location Address Postal Code:

01104-2377

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

413-748-9220

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

06/11/2006

Authorized Official Last Name:

KASSA

Authorized Official First Name:

LAURA

Authorized Official Middle Name:

Authorized Official Title or Position:

SR VICE PRESIDENT

Authorized Official Telephone Number:

904-300-2777

• Taxonomy code: 261QM1200X , with the licence number:  4755 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 1535072 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
• Identifier: 102796500 . This is a "U.S. DEPT OF LABOR OWCP" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 601846 . This is a "HARVARD PILGRIM HLTH CARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 981801 . This is a "NETWORK HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 12749 . This is a "HEALTH NEW ENGLAND" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 0009810 . This is a "NEIGHBORHOOD HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 028869 . This is a "BCBS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 0424620 . This is a "CIGNA / HEALTHSOURCE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 000000006896 . This is a "BOSTON MC HEALTHNET PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 803444 . This is a "TUFTS/SECURE HORIZONS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".