Organization
NORTHWEST MEDICAL CENTER CT MRI AT MARANA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURIE HOLTSFORD (DIRECTOR, BUSINESS OFFICE SERVICES)
(615) 465-7466
Entity
Organization
Contact information
Practice address
8333 N SILVERBELL, SUITE 121, MARANA, AZ 85743
(520) 202-7790
Mailing address
8333 N SILVERBELL, SUITE 121, MARANA, AZ 85743
(520) 202-7790
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
PENDING
AZ
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
PENDING
AZ
261QM1300X
Multi-Specialty Clinic/Center
PENDING
AZ
261QR0200X
Radiology Clinic/Center
PENDING
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
AZ
Enumeration date
08/30/2006
Last updated
11/06/2007
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