Provider Demographics
NPI:1639749526
Name:ALPHA MEDICAL IMAGING SOLUTIONS LLC
Entity Type:Organization
Organization Name:ALPHA MEDICAL IMAGING SOLUTIONS LLC
Other - Org Name:AMERICAN RADIOLOGY GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:POTHEN
Authorized Official - Middle Name:VARUGHESE
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-370-9777
Mailing Address - Street 1:669 BROAD AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07657-1631
Mailing Address - Country:US
Mailing Address - Phone:201-699-0929
Mailing Address - Fax:201-941-0175
Practice Address - Street 1:669 BROAD AVE STE 104
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07657-1631
Practice Address - Country:US
Practice Address - Phone:201-699-0929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-01
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology