Organization
BROOMALL RADIOLOGY ASSOCIATES PC
Active
Organization
BROOMALL RADIOLOGY ASSOCIATES PC
Active
Parent organization
BROOMALL RADIOLOGY ASSOCIATES PC
Other names
Main Line Open MRI
Organization subpart
Yes
Provider details
NPI number
Legal business name
BROOMALL RADIOLOGY ASSOCIATES PC
Authorized official
MIKE CARR (PRESIDENT)
(215) 663-5910
Entity
Organization
Contact information
Practice address
590 REED RD, BROOMALL, PA 19008-3654
(610) 353-7100
(610) 353-7101
Mailing address
PO BOX 827275, PHILADELPHIA, PA 19182-7275
(215) 663-5910
(215) 663-2451
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0013923080001
—
PA
Enumeration date
08/29/2005
Last updated
07/21/2022
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