MOLECULAR IMAGING ALLIANCE OF MILWAUKEE LLC NPI 1679890297

NPI Information

NPI: 1679890297
Provider Name: MOLECULAR IMAGING ALLIANCE OF MILWAUKEE, LLC
Classification: Clinic/Center - 261QR0200X
Entity Type: Organization

Specialization: Radiology

Address:
9200 LEESGATE RD STE 100
LOUISVILLE, KY
ZIP 40222
Phone: (502) 403-1401
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MOLECULAR IMAGING ALLIANCE OF MILWAUKEE, LLC is a radiology clinic center in Louisville, KY. MOLECULAR IMAGING ALLIANCE OF MILWAUKEE, LLC NPI is 1679890297. The provider is registered as an organization entity type.

The provider's business location address is:

9200 LEESGATE RD STE 100
LOUISVILLE, KY
ZIP 40222-173
Phone: (502) 403-1401
Fax: (502) 403-1451

The provider's authorized official is Michelle Douglas .
The authorized official title is Contract Manager and has the following contact phone number (502) 403-1401.

The enumeration date for this NPI number is 4/21/2010 and was last updated on 9/9/2011.

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
1	261QR0200X	Clinic/Center	Radiology			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	100015024	MEDICAID	WISCONSIN
2	WI2046	MEDICARE PIN	WISCONSIN

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: 4/28/2024

NPI Synchronization or Removal

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