Organization
NEHE-MRI, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDY BACON (EXECUTIVE VICE PRESIDENT)
(207) 764-6121
Entity
Organization
Contact information
Practice address
260 MAIN ST, SUITE A, PRESQUE ISLE, ME 04769-2804
(207) 764-6121
(207) 764-1942
Mailing address
260 MAIN ST, SUITE A, PRESQUE ISLE, ME 04769-2804
(207) 764-6121
(207) 764-1942
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
1038924
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2140797
AETNA PROVIDER NUMBER
ME
Enumeration date
08/02/2005
Last updated
08/22/2020
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