Maine Molecular Imaging LLC

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

MAINE MOLECULAR IMAGING LLC

Practice address

149 North St
Waterville, ME 04901-4974

Phone

(800) 734-4132

Fax

(800) 283-2377

NPI assigned

May 5, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Brian G Drazba

Title

Senior V.P. & Chief Accounting Ofcr

Phone

(949) 282-6000

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Maine Molecular Imaging LLC

  • Physiological Laboratory
  • Scarborough, ME
  • NPI 1316995624

  O20041230000236

  Same enrollment
• Maine Molecular Imaging LLC

  • Physiological Laboratory
  • Skowhegan, ME
  • NPI 1316995632

  O20041230000236

  Same enrollment
• Maine Molecular Imaging LLC

  • Physiological Laboratory
  • Lewiston, ME
  • NPI 1972551299

  O20041230000236

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191542400000",
    "number": "1750339065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 414025",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022414025",
            "telephone_number": "949-282-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 NORTH ST",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049014974",
            "telephone_number": "800-734-4132",
            "fax_number": "800-283-2377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAINE MOLECULAR IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2007-10-05",
        "status": "A",
        "authorized_official_last_name": "DRAZBA",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "SENIOR V.P. & CHIEF ACCOUNTING OFCR",
        "authorized_official_telephone_number": "949-282-6000"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maine General Community Care (HealthReach Network)
• Maine General Community Care (HealthReach Network)
• Maine General Community Care (HealthReach Network)
• Maine General Community Care (HealthReach OP Psychiatry)
• Maine Mobile MRI Assoc (Maine MRI Associates)
• Maine Physical Therapy Limited Partnership
• Maine Plastic Surgical Associates PA
• Maine Recovery Partners LLC
• Mainegeneral Community Care (Healthreach Network)
• Mainegeneral Community Care (HealthReach Network)

• Physiological Laboratory in Waterville, ME
• Providers in Waterville, ME by specialty
• Physiological Laboratory in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.