Organization
NEW ENGLAND MOLECULAR IMAGING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RHONDA LONGMORE GRUND (EXEC VP & CFO)
(800) 544-3215
Entity
Organization
Contact information
Practice address
300 MAIN ST, LEWISTON, ME 04240-7007
(207) 795-0111
Mailing address
100 BAYVIEW CIRCLE, SUITE 400, NEWPORT BEACH, CA 92660-2984
(800) 544-3215
Taxonomy
Speciality
Code
Description
License number
State
261QR0208X
Mobile Radiology Clinic/Center
Primary
01601
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
043913
ANTHEM BLUE CROSS
ME
01
—
129019400
U.S. DEPT OF LABOR OWCP
ME
05
—
166060000
—
ME
01
—
7695348
AETNA
ME
01
—
800942
HARVARD PILGRIM HLTH CARE
ME
Enumeration date
06/19/2006
Last updated
10/19/2016
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