Organization
NEWISCONSIN MRI CENTER OF GREEN BAY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CINDY LEMMER (CHIEF FINANCIAL OFFICER)
(920) 431-7120
Entity
Organization
Contact information
Practice address
2141 LIME KILN RD, GREEN BAY, WI 54311-6215
(920) 431-7120
(920) 431-7537
Mailing address
2141 LIME KILN RD, GREEN BAY, WI 54311-6215
(920) 431-7120
(920) 431-7537
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1059612001
AMERICHOICE MEDICAID
WI
05
—
21297900
—
WI
Enumeration date
05/26/2006
Last updated
04/20/2008
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