Provider Demographics
NPI:1396703096
Name:INDEPENDENT MRI CENTER LLC
Entity type:Organization
Organization Name:INDEPENDENT MRI CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER-PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:MORRIS
Authorized Official - Last Name:SALTZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:505-327-0333
Mailing Address - Street 1:1750 E 30TH ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401-9020
Mailing Address - Country:US
Mailing Address - Phone:505-327-0123
Mailing Address - Fax:505-327-0127
Practice Address - Street 1:1750 E 30TH ST
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-9020
Practice Address - Country:US
Practice Address - Phone:505-327-0123
Practice Address - Fax:505-327-0127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-02
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)