1528191228 NPI number — ATRIUS HEALTH, INC.

Table of content: (NPI 1528191228)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528191228 NPI number — ATRIUS HEALTH, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ATRIUS HEALTH, 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:
HARVARD VANGUARD MEDICAL ASSOCIATES
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:
1528191228
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
275 GROVE ST
Provider Second Line Business Mailing Address:
SUITE 3-300
Provider Business Mailing Address City Name:
AUBURNDALE
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02466-2272
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-559-8005
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
165 DARTMOUTH 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:
02116-5123
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-859-5300
Provider Business Practice Location Address Fax Number:
617-859-5315
Provider Enumeration Date:
03/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
CARDARELLI
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
J.
Authorized Official Title or Position:
DIRECTOR OF PHARMACY REVENUE AND SU
Authorized Official Telephone Number:
617-972-5321

Provider Taxonomy Codes

  • Taxonomy code: 3336C0002X , with the licence number:  MA0054534 , 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: 0402541 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2229638 . This is a "NCPDP" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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