Organization
STEWARD PET IMAGING, L.L.C.
Active
Parent organization
STEWARD PET IMAGING, LLC
Other names
Steward PET Imaging, LLC at Good Samaritan Medical Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
STEWARD PET IMAGING, LLC
Authorized official
MR. ROBERT E GUYON JR. (COO)
(617) 789-5047
Entity
Organization
Contact information
Practice address
235 NORTH PEARL STREET, BROCKTON, MA 02301-1794
(877) 877-8455
(866) 927-0079
Mailing address
800 WASHINGTON ST, NORWOOD, MA 02062-3487
(877) 877-8455
(866) 927-0079
Taxonomy
Speciality
Code
Description
License number
State
261QR0208X
Mobile Radiology Clinic/Center
Primary
4NNJ
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110073236G
—
MA
Enumeration date
08/25/2008
Last updated
01/19/2011
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