Provider Demographics
NPI:1275606253
Name:SSMRI LLC
Entity Type:Organization
Organization Name:SSMRI LLC
Other - Org Name:LOWELL MEDICAL IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RADIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:RINER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:479-770-6333
Mailing Address - Street 1:108 CROSSOVER AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:LOWELL
Mailing Address - State:AR
Mailing Address - Zip Code:72745-8937
Mailing Address - Country:US
Mailing Address - Phone:479-770-6333
Mailing Address - Fax:479-770-8033
Practice Address - Street 1:5501 WILLOW CREEK DR
Practice Address - Street 2:SUITE 200
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-8704
Practice Address - Country:US
Practice Address - Phone:479-442-4553
Practice Address - Fax:479-251-1006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC47502085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5C341Medicare ID - Type Unspecified