Provider Demographics
NPI:1851909360
Name:MAMMOGRAPHY PARTNERS LLC
Entity Type:Organization
Organization Name:MAMMOGRAPHY PARTNERS LLC
Other - Org Name:MAVEN MAMMOGRAPHY
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:A
Authorized Official - Last Name:HAMMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-384-3512
Mailing Address - Street 1:PO BOX 96416
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28296-0416
Mailing Address - Country:US
Mailing Address - Phone:904-807-5272
Mailing Address - Fax:904-389-8699
Practice Address - Street 1:7860 GATE PARKWAY
Practice Address - Street 2:PARKING LOT
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-3225
Practice Address - Country:US
Practice Address - Phone:904-807-5272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-21
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0207XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile Mammography