Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with Derry Imaging before sending sensitive documents. FaxFlow is not affiliated with this organization.
Derry Imaging fax number
(603) 537-3046
Imaging Orders / Prior Authorization
Used for: Imaging orders and authorization communications (MRI/CT orders, prior authorization).
Fax destination details
- Department
- Imaging Orders / Prior Authorization
- Purpose
- Imaging orders and authorization communications (MRI/CT orders, prior authorization).
- Form
- Order Form — MRI/CT Order Form
- Address
- Overlook Medical Park, 6 Tsienneto Road, Suite LL100, Derry, NH 03038; Bedford location: 160 South River Road, Suite 2100, Bedford, NH 03110
- Voice phone
- (603) 537-1363
- Website
- Visit organization website
Before you send
- Confirm that this exact department handles your document or request.
- Check the organization website or call its main line for the current fax number.
- Include a cover sheet and any case, member, claim, or form reference required.
- Keep the delivery confirmation with your submission records.
Fill in patient name, date of birth, exam type (MRI/MRA/CT/CTA), referring physician, insurance information, and scan details; include any required authorization information and patient demographics, then fax to the provided MRI/CT Fax number.
Official form instructions are published as a downloadable file on the organization's website.
Sources and verification
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