Evergreen Imaging Center, Llc

LBN: Evergreen Imaging Center, Llc
Evergreen Imaging Center, Llc is an health care organization with primary practice located at 2800 Tamarack Ave Suite 002, South Windsor CT 06074. The organization recently has only one registered license in Ambulatory Health Care Facilities / Radiology, which is considered as the primary health care specialty. Evergreen Imaging Center, Llc can be contacted via phone (860) 533-4600, or through Mcconville, Dennis Patrick via phone (860) 533-3429.

Contact Information

Primary practice address
2800 Tamarack Ave Suite 002 South Windsor CT 06074
Phone: (860) 533-4600
Fax: (860) 533-4601
Website:
Map and Directions
Authorized official contact:
Name: Mcconville, Dennis Patrick
Phone: (860) 533-3429

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Radiology 261QR0200X

Profile Details

NPI number 1316050925
LBN Legal business name Evergreen Imaging Center, Llc
DBA Doing business as
Authorized official Mcconville, Dennis Patrick
Entity Organization
Organization subpart 1 No
Enumeration date Aug 16th, 2006
Last updated Nov 10th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1316050925 NPPES
Connecticut MEDICAID 004261351

Popular Providers