1215276415 NPI number — NESC LPHO LLC

Table of content: (NPI 1215276415)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215276415 NPI number — NESC LPHO LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NESC LPHO LLC
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:
NORTHEAST SURGERY CENTER LLC
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:
1215276415
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/22/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
27 VILLAGE SQ
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHELMSFORD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01824-2712
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-244-0060
Provider Business Mailing Address Fax Number:
978-244-2522

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
33 VILLAGE SQ
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHELMSFORD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01824-2712
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-244-0060
Provider Business Practice Location Address Fax Number:
978-244-2522
Provider Enumeration Date:
02/07/2013

Additional Information

Authorized Official

Authorized Official Last Name:
DALTON
Authorized Official First Name:
MARGARET
Authorized Official Middle Name:
Authorized Official Title or Position:
PRACTICE ADMINISTRATOR
Authorized Official Telephone Number:
978-244-0060

Provider Taxonomy Codes

  • Taxonomy code: 207ND0101X , with the licence number:  79526 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207ND0101X , with the licence number: 153438 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207W00000X , with the licence number: 160016 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208200000X , with the licence number: 205725 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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