1184834434 NPI number — HEALING CHOICES, PC

Table of content: (NPI 1184834434)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184834434 NPI number — HEALING CHOICES, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALING CHOICES, 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:
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:
1184834434
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/06/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
89 MAIN ST
Provider Second Line Business Mailing Address:
SUITE 112
Provider Business Mailing Address City Name:
MEDWAY
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02053-1828
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-533-1110
Provider Business Mailing Address Fax Number:
508-533-1120

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
89 MAIN ST
Provider Second Line Business Practice Location Address:
SUITE 112
Provider Business Practice Location Address City Name:
MEDWAY
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02053-1828
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-533-1110
Provider Business Practice Location Address Fax Number:
508-533-1120
Provider Enumeration Date:
05/23/2007

Additional Information

Authorized Official

Authorized Official Last Name:
RAFAL
Authorized Official First Name:
KEITH
Authorized Official Middle Name:
WL
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
508-533-1110

Provider Taxonomy Codes

  • Taxonomy code: 2081H0002X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 8725377002 . This is a "RI CIGNA" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 23-00080 . This is a "UNITED HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 23-00181 . This is a "MEDICARE COMPLETE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7680569 . This is a "COMMERCIAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 22166 . This is a "RI BLUE CROSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3020185 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 405187 . This is a "BLUE CHIP" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 4197 . This is a "NEIGHBORHOOD" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: J06887 . This is a "MA BC" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 22534 . This is a "PILGRIM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 3020185 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 80579 . This is a "HARVARD PILGRIM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 2567536 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 404632 . This is a "TUFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com