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Organization

MOBILE MEDICAL RADIOGRAPHY AND EKG INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. MINDA DE MEDEIROS MHA (VP OF ADMINISTRATIVE SERVICES)
(508) 923-6171
Entity
Organization

Contact information

Practice address
109 RHODE ISLAND RD, CLEAR POND OFFICES, LAKEVILLE, MA 02347-1370
(508) 923-6171
(508) 923-6248
Mailing address
109 RHODE ISLAND RD, CLEAR POND OFFICES, LAKEVILLE, MA 02347-1370
(508) 923-6171
(508) 923-6248

Taxonomy

Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
08305
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1536591
MA
01
209805
MEDICARE PROVIDER NUMBER
ME
Enumeration date
10/31/2005
Last updated
12/13/2007
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