Evergreen Imaging Center, LLC
NPI #1316050925 in South Windsor, Connecticut
Provider Information
- NPI Number
- 1316050925
- Entity Type
- Organization
- Organization Name
- Evergreen Imaging Center, LLC
- Primary Specialty
- Clinic/Center - Radiology
- Enumeration Date
- Aug 16, 2006
- Last Updated
- Nov 10, 2008
Practice Location
- Address
- 2800 TAMARACK AVE
- Address 2
- SUITE 002
- City
- South Windsor
- State
- Connecticut
- ZIP Code
- 06074
- Phone
- (860) 533-4600
Authorized Official
- Name
- MR. DENNIS PATRICK MCCONVILLE
- Title
- DIRECTOR
- Phone
- (860) 533-3429
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Radiology — Radiology |
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