# NORTHWEST MEDICAL CENTER CT MRI AT MARANA LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679682900
- **Authorized official:** LAURIE HOLTSFORD (DIRECTOR, BUSINESS OFFICE SERVICES)
- **Authorized official phone:** (615) 465-7466

## Contact information

- **Practice address:** 8333 N SILVERBELL, SUITE 121, MARANA, AZ 85743
- **Practice address phone:** (520) 202-7790
- **Mailing address:** 8333 N SILVERBELL, SUITE 121, MARANA, AZ 85743
- **Mailing address phone:** (520) 202-7790

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | PENDING | AZ | — |
| 261QM1200X | Magnetic Resonance Imaging (MRI) Clinic/Center | PENDING | AZ | Yes |
| 261QM1300X | Multi-Specialty Clinic/Center | PENDING | AZ | — |
| 261QR0200X | Radiology Clinic/Center | PENDING | AZ | — |

## Other

- **Enumeration date:** 08/30/2006
- **Last updated:** 11/06/2007