Provider Demographics
NPI:1609755412
Name:MIDSHORE IMAGING LLC
Entity type:Organization
Organization Name:MIDSHORE IMAGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTIANNA
Authorized Official - Middle Name:L
Authorized Official - Last Name:EDDY
Authorized Official - Suffix:
Authorized Official - Credentials:RDMS, RVT
Authorized Official - Phone:484-336-0339
Mailing Address - Street 1:23000 SUSSEX HWY # 237
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19973-5866
Mailing Address - Country:US
Mailing Address - Phone:410-936-0672
Mailing Address - Fax:855-975-2622
Practice Address - Street 1:4182 OSBORNE RD
Practice Address - Street 2:
Practice Address - City:HURLOCK
Practice Address - State:MD
Practice Address - Zip Code:21643-3000
Practice Address - Country:US
Practice Address - Phone:410-936-0672
Practice Address - Fax:855-975-2622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-27
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology