Basic Information
| Provider Information | |||||||||
| NPI: | 1598707093 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GREATER SPRINGFIELD MRI LIMITED PARTNERSHIP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 18201 VON KARMAN AVE STE 600 | ||||||||
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| City: | IRVINE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926121176 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9492425592 | ||||||||
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| Practice Location | |||||||||
| Address1: | 271 CAREW ST | ||||||||
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| City: | SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 011042377 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4137489220 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2006 | ||||||||
| LastUpdateDate: | 12/30/2019 | ||||||||
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| AuthorizedOfficialLastName: | LARKIN | ||||||||
| AuthorizedOfficialFirstName: | WILLIAM | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 8005443215 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 12/30/2019 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM1200X | 4755 | MA | Y | Ambulatory Health Care Facilities | Clinic/Center | Magnetic Resonance Imaging (MRI) |
ID Information
| ID | Type | State | Issuer | Description | 981801 | 01 | MA | NETWORK HEALTH | OTHER | 000000006896 | 01 | MA | BOSTON MC HEALTHNET PLAN | OTHER | 0424620 | 01 | MA | CIGNA / HEALTHSOURCE | OTHER | 1535072 | 05 | MA | MEDICAID | 803444 | 01 | MA | TUFTS/SECURE HORIZONS | OTHER | 601846 | 01 | MA | HARVARD PILGRIM HLTH CARE | OTHER | 028869 | 01 | MA | BCBS | OTHER | 102796500 | 01 | MA | U.S. DEPT OF LABOR OWCP | OTHER | 0009810 | 01 | MA | NEIGHBORHOOD HEALTH PLAN | OTHER | 12749 | 01 | MA | HEALTH NEW ENGLAND | OTHER |