Provider Demographics
NPI:1891252789
Name:ISLAND ECHO, LLC
Entity Type:Organization
Organization Name:ISLAND ECHO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED CARDIAC SONOGRAPHER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:GEORGIANNA
Authorized Official - Last Name:MORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RCS
Authorized Official - Phone:815-712-3140
Mailing Address - Street 1:5110 TIDE VLG
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00820-4594
Mailing Address - Country:US
Mailing Address - Phone:815-712-3140
Mailing Address - Fax:
Practice Address - Street 1:5110 TIDE VLG
Practice Address - Street 2:
Practice Address - City:CHRISTIANSTED
Practice Address - State:VI
Practice Address - Zip Code:00820-4594
Practice Address - Country:US
Practice Address - Phone:815-712-3140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-27
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile