Provider Demographics
NPI:1992946230
Name:RADISERV LLC
Entity type:Organization
Organization Name:RADISERV LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEIF OPERATIONS OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ALPITA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-973-5133
Mailing Address - Street 1:8 FANEUIL HALL MARKETPLACE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02109-0000
Mailing Address - Country:US
Mailing Address - Phone:617-973-5133
Mailing Address - Fax:617-300-8668
Practice Address - Street 1:4224 W TENNESSEE ST # 205
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32304-1033
Practice Address - Country:US
Practice Address - Phone:617-973-5133
Practice Address - Fax:617-300-8668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-17
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty