Provider Demographics
NPI:1457304081
Name:NEHI-HOULTON MRI, LLC
Entity Type:Organization
Organization Name:NEHI-HOULTON MRI, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SVP CORPORATEFINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:POAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-242-5321
Mailing Address - Street 1:100 BAYVIEW CIRCLE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2984
Mailing Address - Country:US
Mailing Address - Phone:949-242-5592
Mailing Address - Fax:602-773-3622
Practice Address - Street 1:20 HARTFORD ST
Practice Address - Street 2:
Practice Address - City:HOULTON
Practice Address - State:ME
Practice Address - Zip Code:04730-1891
Practice Address - Country:US
Practice Address - Phone:207-764-6121
Practice Address - Fax:207-764-1942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology