Organization
PREMIER DIAGNOSTIC SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRYON L BECKER (VP)
(508) 584-5600
Entity
Organization
Contact information
Practice address
378 PAGE ST., SUITE 101, STOUGHTON, MA 02072-1124
(800) 346-2111
(508) 584-6362
Mailing address
378 PAGE ST., SUITE 101, STOUGHTON, MA 02072-1124
(800) 346-2111
(508) 584-6362
Taxonomy
Speciality
Code
Description
License number
State
246W00000X
Cardiology Technician
—
—
246XS1301X
Sonography Specialist/Technologist Cardiovascular
—
—
246ZE0500X
EEG Specialist/Technologist
—
—
2471B0102X
Bone Densitometry Radiologic Technologist
—
—
2471S1302X
Sonography Radiologic Technologist
Primary
—
—
2471V0105X
Vascular Sonography Radiologic Technologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041169
BCMA IPDL#
MA
05
—
1526260
—
MA
05
—
1850091
—
MA
01
—
327019
MA BC PROV
MA
01
—
76Y00737NH01
NH ANTHEM BC PROV
NH
Enumeration date
06/22/2005
Last updated
03/20/2023
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