Provider Demographics
NPI:1184017022
Name:PARTNERS IN THE IMAGING ENTERPRISE, LLC
Entity Type:Organization
Organization Name:PARTNERS IN THE IMAGING ENTERPRISE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:BERGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:208-771-0641
Mailing Address - Street 1:PO BOX 639
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83816-0639
Mailing Address - Country:US
Mailing Address - Phone:208-771-0641
Mailing Address - Fax:
Practice Address - Street 1:5171 S SEEWEEWANA CT
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:ID
Practice Address - Zip Code:83833-6051
Practice Address - Country:US
Practice Address - Phone:208-771-0641
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-17
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM6950174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDF51051Medicare UPIN