1386640597 NPI number — ALL CARE VISITING NURSE ASSOCIATION OF GREATER LYNN INC.

Table of content: (NPI 1386640597)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386640597 NPI number — ALL CARE VISITING NURSE ASSOCIATION OF GREATER LYNN INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALL CARE VISITING NURSE ASSOCIATION OF GREATER LYNN 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:
1386640597
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
210 MARKET ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LYNN
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01901-1536
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
781-598-2454
Provider Business Mailing Address Fax Number:
781-586-1639

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
210 MARKET 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:
01901-1536
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-598-2454
Provider Business Practice Location Address Fax Number:
781-586-1639
Provider Enumeration Date:
06/22/2005

Additional Information

Authorized Official

Authorized Official Last Name:
KOOPMAN
Authorized Official First Name:
JO-MARY
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT/CEO
Authorized Official Telephone Number:
781-598-2454

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , 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: 702778 . This is a "TUFTS HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 581177 . This is a "AETNA HMO/PPO" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0600822 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 120012 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 20280 . This is a "BOSTON MEDICAL HEALTHNET" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 702042 . This is a "HARVARD COMM. HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 32144 . This is a "FALLON COMMUNITY HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0007532 . This is a "NEIGHBORHOOD HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com