1225028939 NPI number — MILFORD EMERGENCY ASSOCIATES, INC

Table of content: (NPI 1225028939)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225028939 NPI number — MILFORD EMERGENCY ASSOCIATES, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MILFORD EMERGENCY 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:
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:
1225028939
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:
14 ASYLUM ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MILFORD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01757-2203
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-473-5500
Provider Business Mailing Address Fax Number:
508-478-6247

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14 ASYLUM ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MILFORD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01757-2203
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-473-5500
Provider Business Practice Location Address Fax Number:
508-478-6247
Provider Enumeration Date:
10/25/2005

Additional Information

Authorized Official

Authorized Official Last Name:
PUOPOLO
Authorized Official First Name:
ANTHONY
Authorized Official Middle Name:
DAVID
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
508-473-5500

Provider Taxonomy Codes

  • Taxonomy code: 261QU0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 032956 . This is a "TUFTS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 34393 . This is a "H.C.H.P" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 2002418 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 758598 . This is a "TUFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: C10014 . This is a "BLUE CROSS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 17661 . This is a "CIGNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 9714243 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: M12700 . This is a "BLUE CROSS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com