Provider Demographics
NPI:1548685753
Name:SPERO MEDICAL IMAGING LLC
Entity type:Organization
Organization Name:SPERO MEDICAL IMAGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:FARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-593-7501
Mailing Address - Street 1:PO BOX 1169
Mailing Address - Street 2:
Mailing Address - City:ROCKLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04841-1169
Mailing Address - Country:US
Mailing Address - Phone:207-593-7501
Mailing Address - Fax:207-594-2433
Practice Address - Street 1:17020 E US HIGHWAY 40
Practice Address - Street 2:SUITE 4
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-5361
Practice Address - Country:US
Practice Address - Phone:816-478-4422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-25
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)