Provider Demographics
NPI:1891470977
Name:PREMIER IMAGING SOLUTIONS NORCAL LLC
Entity Type:Organization
Organization Name:PREMIER IMAGING SOLUTIONS NORCAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QUALITY AND COMPLIANCE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-484-0188
Mailing Address - Street 1:3440 N 16TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-7125
Mailing Address - Country:US
Mailing Address - Phone:605-484-0188
Mailing Address - Fax:
Practice Address - Street 1:4630 NORTHGATE BLVD STE 150
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-1141
Practice Address - Country:US
Practice Address - Phone:877-211-4523
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-16
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier