Basic Information
| Provider Information | |||||||||
| NPI: | 1679030415 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | IMAGECARE LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 57 ROUTE 46 STE 212 | ||||||||
| Address2: | |||||||||
| City: | HACKETTSTOWN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 078402695 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9089791621 | ||||||||
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| Practice Location | |||||||||
| Address1: | 57 ROUTE 46 STE 212 | ||||||||
| Address2: | |||||||||
| City: | HACKETTSTOWN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 078402695 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9089791621 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/28/2019 | ||||||||
| LastUpdateDate: | 02/28/2019 | ||||||||
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| AuthorizedOfficialLastName: | HINRICHS | ||||||||
| AuthorizedOfficialFirstName: | CLAY | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | MANAGING PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 7327134299 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0200X | Y | Ambulatory Health Care Facilities | Clinic/Center | Radiology |
No ID Information.