Provider Demographics
NPI:1437364965
Name:NEW HAMPSHIRE OPEN MRI LLC
Entity Type:Organization
Organization Name:NEW HAMPSHIRE OPEN MRI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:C
Authorized Official - Last Name:KUMMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-863-1249
Mailing Address - Street 1:8 COMMERCE AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:WEST LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03784-1669
Mailing Address - Country:US
Mailing Address - Phone:603-298-6736
Mailing Address - Fax:603-298-6737
Practice Address - Street 1:8 COMMERCE AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:WEST LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03784-1669
Practice Address - Country:US
Practice Address - Phone:603-298-6736
Practice Address - Fax:603-298-6737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30816062Medicaid
VT1014020Medicaid
NH30816062Medicaid