Organization
ALLIANCE CARE MOBILE X-RAY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROMAIN D VOUFO RT (CEO)
(857) 237-9005
Entity
Organization
Contact information
Practice address
44 W EMERSON ST APT 11, MELROSE, MA 02176-3131
(857) 237-9005
Mailing address
44 W EMERSON ST APT 11, MELROSE, MA 02176-3131
(857) 237-9005
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
14175
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110090095A
—
MA
01
—
22X0009831
MEDICARE
MA
Enumeration date
03/24/2011
Last updated
10/21/2011
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