| Organization Name: | MAINE MOLECULAR IMAGING LLC |
| NPI Number: | 1316995632 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRIAN G DRAZBA (SENIOR V.P. & CHIEF ACCOUNTING OFCR) |
| Mailing Address: | 46 Fairview Ave Skowhegan |
| State: | ME US |
| Postal Code: | 049761481 |
| Phone Number: | 8007344132 |
| Fax Number: | 8002732377 |
| NPI Enumeration Date: | 05/05/2006 |
| NPI Last Update Date: | 10/05/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 293D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Laboratories |
| Taxonomy Classification: | Physiological Laboratory |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A laboratory that operates independently of a hospital and physician |