1851327076 NPI number — ENHANCED IMAGING LLC

Table of content: (NPI 1851327076)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851327076 NPI number — ENHANCED IMAGING LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ENHANCED IMAGING LLC
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:
1851327076
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AMHERST
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03031-4200
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-673-9411
Provider Business Mailing Address Fax Number:
603-673-9899

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3 MEETING HOUSE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHELMSFORD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01824-2738
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-649-7004
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/23/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
RUTIGLIANO
Authorized Official First Name:
SAMUEL
Authorized Official Middle Name:
W
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
978-649-7004

Provider Taxonomy Codes

  • Taxonomy code: 2471S1302X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 7962690 . This is a "AETNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 040669 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".