1386702264 NPI number — BAY COVE HUMAN SERVICES, INC

Table of content: ALAN DAVID HUBER P.A. (NPI 1629000591)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386702264 NPI number — BAY COVE HUMAN SERVICES, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BAY COVE HUMAN SERVICES, INC
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:
Provider Other Organization Name Type Code:
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:
1386702264
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/07/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
66 CANAL ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BOSTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02114-2002
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-371-3000
Provider Business Mailing Address Fax Number:
617-371-3100

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
31 BOWKER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BOSTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02114-2917
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-371-3000
Provider Business Practice Location Address Fax Number:
617-371-3100
Provider Enumeration Date:
12/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SPRAGUE
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
H
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
617-371-3003

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1302272 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000008433 . This is a "BMC HEALTHNET PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1306448 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1000290 . This is a "BHS (NHP AND FALLON)" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1306448 . This is a "MBHP" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 98738301 . This is a "NETWORK HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1307681 . This is a "MBHP" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 99621101 . This is a "NETWORK HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 000000008416 . This is a "BMC HEALTHNET PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1310194 . This is a "MBHP" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: BOS2225003301 . This is a "BLUE CROSS BLUE SHIELD MA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 796212 . This is a "NETWORK HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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