1982687497 NPI number — CITY OF LYNN MASSACHUSETTS

Table of content: (NPI 1982687497)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982687497 NPI number — CITY OF LYNN MASSACHUSETTS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF LYNN MASSACHUSETTS
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:
1982687497
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/13/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8 TURCOTTE MEMORIAL DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROWLEY
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01969-1706
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-488-4351
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
73 HOLLINGSWORTH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LYNN
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-593-1234
Provider Business Practice Location Address Fax Number:
781-596-1480
Provider Enumeration Date:
11/29/2005

Additional Information

Authorized Official

Authorized Official Last Name:
ZUKAS
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
Authorized Official Title or Position:
CAPTAIN
Authorized Official Telephone Number:
781-593-7528

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  3033 , 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: 155967XX . This is a "PREFERRED CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1720040 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 704323 . This is a "HARVARD PILGRIM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 103514000 . This is a "US DEPARTMENT OF LABOR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0020271 . This is a "NEIGHBORHOOD HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 806813 . This is a "TUFTS HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000021757 . This is a "BMC HEALTHNET" identifier . This identifiers is of the category "OTHER".
  • Identifier: AM0087 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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