Provider Demographics
NPI:1326104753
Name:ORTHOPAEDIC & NEURO IMAGING LLC
Entity Type:Organization
Organization Name:ORTHOPAEDIC & NEURO IMAGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICK
Authorized Official - Middle Name:
Authorized Official - Last Name:PFARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-644-7335
Mailing Address - Street 1:34435 KING STREET ROW
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-4787
Mailing Address - Country:US
Mailing Address - Phone:302-644-7335
Mailing Address - Fax:
Practice Address - Street 1:34435 KING STREET ROW
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-4787
Practice Address - Country:US
Practice Address - Phone:302-644-7335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody ImagingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD409531600Medicaid
DE1000016103Medicaid
MDKEU80ROtherBLUE SHIELD
DCG556OtherGHI
MD409531600Medicaid
DE1000016103Medicaid
MD470001867Medicare PIN