Organization
MAINE MOLECULAR IMAGING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN G DRAZBA (SENIOR V.P. & CHIEF ACCOUNTING OFCR)
(949) 282-6000
Entity
Organization
Contact information
Practice address
360 BROADWAY, BANGOR, ME 04401-3979
(800) 734-4132
(800) 273-2377
Mailing address
PO BOX 414025, BOSTON, MA 02241-4025
(949) 282-6000
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
—
—
Other
Enumeration date
05/05/2006
Last updated
10/05/2007
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