| Organization Name: | NORTHWEST RADIOLOGY |
| NPI Number: | 1104098441 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PETER BANCROFT (CEO) |
| Mailing Address: | 36 Bridge Way Pascoag |
| State: | RI US |
| Postal Code: | 028593131 |
| Phone Number: | 4015687661 |
| Fax Number: | 4015670900 |
| NPI Enumeration Date: | 03/27/2008 |
| NPI Last Update Date: | 04/16/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0200X |
| License Number: | RAD0142 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | RI |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Radiology |
| Taxonomy Definition: | |