Organization
CONCORD IMAGING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY J MCCORMACK MD (DIRECTOR)
(603) 228-1521
Entity
Organization
Contact information
Practice address
2 1/2 BEACON ST, CONCORD, NH 03301-4447
(603) 228-1521
(603) 225-2510
Mailing address
2 1/2 BEACON ST, CONCORD, NH 03301-4447
(603) 228-1521
(603) 225-2510
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
—
—
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
—
—
261QR0200X
Radiology Clinic/Center
Primary
—
—
261QR0206X
Mammography Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30814375
—
NH
01
—
CB4403
RAILROAD MEDICARE
NH
01
—
CONC300975
ANTHEM BCBS OF NH
NH
Enumeration date
02/10/2006
Last updated
07/31/2020
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