Provider Demographics
NPI:1710942875
Name:INSIGHT-PREMIER HEALTH LLC
Entity Type:Organization
Organization Name:INSIGHT-PREMIER HEALTH LLC
Other - Org Name:RAYUS RADIOLOGY MARSHWOOD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SPECIAL ASSISTANT SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:RAMONA
Authorized Official - Middle Name:L
Authorized Official - Last Name:AHERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-738-4441
Mailing Address - Street 1:PO BOX 414025
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-4025
Mailing Address - Country:US
Mailing Address - Phone:866-674-7933
Mailing Address - Fax:
Practice Address - Street 1:33 GORHAM RD
Practice Address - Street 2:
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-9552
Practice Address - Country:US
Practice Address - Phone:207-883-3803
Practice Address - Fax:207-883-6370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME470001124OtherRAILROAD MEDICARE
ME133960002Medicaid