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EVERGREEN VALLEY MEDICAL PC NPI 1225171630


NPI Information

NPI: 1225171630
Provider Name: EVERGREEN VALLEY MEDICAL, PC
Classification: Portable X-ray and/or Other Portable Diagnostic Imaging Supplier - 335V00000X
Entity Type: Organization
Address:
170 TILTING ROCK RD
WRENTHAM, MA
ZIP 02093
Phone: (508) 930-7659
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EVERGREEN VALLEY MEDICAL, PC is a portable x ray and or other portable diagnostic imaging supplier in Wrentham, MA. The provider is a supplier that provides one or more of the following portable services, including but not limited to, x-ray, electrocardiogram (EKG), long-term EKG (Holter Monitor), bone densitometry, sonography, and other imaging services in accordance with all state and federal requirements, under the general supervision of a qualified physician. All necessary resources are transported to the patient's location where the services are performed. EVERGREEN VALLEY MEDICAL, PC NPI is 1225171630. The provider is registered as an organization entity type.

The provider's business location address is:

170 TILTING ROCK RD
WRENTHAM, MA
ZIP 02093-358
Phone: (508) 930-7659

The provider's authorized official is Michael Fagien .
The authorized official title is Owner and has the following contact phone number (508) 930-7659.

The enumeration date for this NPI number is 2/15/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1335V00000XPortable X-ray and/or Other Portable Diagnostic Imaging SupplierYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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