Organization
MAINE MOLECULAR IMAGING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAMONA L AHERN (SPECIAL ASSISTANT SECRETARY)
(952) 738-4441
Entity
Organization
Contact information
Practice address
123 MEDICAL CENTER DR, BRUNSWICK, ME 04011-2652
(800) 734-4132
(800) 273-2377
Mailing address
PO BOX 414025, BOSTON, MA 02241-4025
(949) 282-6000
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
170500000
—
ME
01
—
470001736
RAILROAD MEDICARE
ME
Enumeration date
05/05/2006
Last updated
08/26/2019
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