1346353604 NPI number — MURRAY BEDFORD PC

Table of content: (NPI 1346353604)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346353604 NPI number — MURRAY BEDFORD PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MURRAY BEDFORD PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
MURRAY & GLYNN PC
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346353604
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/17/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
222 CAREW ST STE 301
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPRINGFIELD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01104-4103
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
222 CAREW ST STE 301
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRINGFIELD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01104-4103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-732-4478
Provider Business Practice Location Address Fax Number:
413-732-7059
Provider Enumeration Date:
08/17/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MURRAY
Authorized Official First Name:
FRANCIS
Authorized Official Middle Name:
DOLAN
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
413-732-4478

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207RX0202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 9703039 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: CH5419 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".