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Organization
MASSACHUSETTS MOBILE PET PC
Active
Organization
MASSACHUSETTS MOBILE PET PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK R TAYLOR (CEO)
(978) 933-9311
Entity
Organization
Contact information
Practice address
140 LINCOLN AVE, HAVERHILL, MA 01830-6700
(978) 689-4738
(978) 682-0984
Mailing address
35 NEW ENGLAND BUSINESS CENTER DR STE 103, ANDOVER, MA 01810-1080
(978) 933-9302
(978) 933-7820
Taxonomy
Speciality
Code
Description
License number
State
261QR0208X
Mobile Radiology Clinic/Center
Primary
44-0373
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0032507
NEIGHBORHOOD HEALTH
—
01
—
3137889
AETNA
—
01
—
696200
TUFTS
—
01
—
706023
HARVARD PILGRIM
—
05
—
972781
—
MA
01
—
M18139
BLUE CROSS OF MA
—
Enumeration date
05/25/2006
Last updated
01/16/2025
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