1679638316 NPI number — NAUSET HEALTH ASSOCIATES, INC.

Table of content: (NPI 1679638316)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679638316 NPI number — NAUSET HEALTH ASSOCIATES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NAUSET HEALTH ASSOCIATES, 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:
DEVEUVE CHIROPRACTIC
Provider Other Organization Name Type Code:
3
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:
1679638316
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
62 RT 6A STE A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORLEANS
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02653-2463
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-255-8686
Provider Business Mailing Address Fax Number:
508-255-6428

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
62 RT 6A
Provider Second Line Business Practice Location Address:
STE A
Provider Business Practice Location Address City Name:
ORLEANS
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02653-2463
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-255-8686
Provider Business Practice Location Address Fax Number:
508-255-6428
Provider Enumeration Date:
12/22/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
DEVEUVE
Authorized Official First Name:
LORI
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
508-255-8686

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: Y39570 . This is a "BCBS MA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".