Provider Demographics
NPI:1063007219
Name:ORCHARD IMAGING, LLC
Entity Type:Organization
Organization Name:ORCHARD IMAGING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:RT
Authorized Official - Phone:603-685-4781
Mailing Address - Street 1:19 KEEWAYDIN DR STE 2
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-4891
Mailing Address - Country:US
Mailing Address - Phone:603-685-4781
Mailing Address - Fax:603-458-1426
Practice Address - Street 1:19 KEEWAYDIN DR STE 2
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-4891
Practice Address - Country:US
Practice Address - Phone:603-685-4781
Practice Address - Fax:603-458-1426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-09
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology