Provider Demographics
NPI:1003910688
Name:NOL, LLC
Entity Type:Organization
Organization Name:NOL, LLC
Other - Org Name:PREMIER RADIOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:M
Authorized Official - Last Name:HARRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-218-9369
Mailing Address - Street 1:PO BOX 440514
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37244-0514
Mailing Address - Country:US
Mailing Address - Phone:615-851-6033
Mailing Address - Fax:615-994-8488
Practice Address - Street 1:1210 BRIARVILLE RD
Practice Address - Street 2:SUITE 602-F
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-5141
Practice Address - Country:US
Practice Address - Phone:615-986-6411
Practice Address - Fax:615-986-6412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody ImagingGroup - Multi-Specialty
No2085D0003XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic NeuroimagingGroup - Multi-Specialty
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiologyGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0139565OtherBCBS
TN3719420Medicaid
TNCG1374OtherRAILROAD MEDICARE
TN3719420Medicare PIN