1508923236 NPI number — ARLINGTON REST HOME, INC.

Table of content: MICHELLE HIEN PHAM PHARM.D. (NPI 1912449406)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508923236 NPI number — ARLINGTON REST HOME, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARLINGTON REST HOME, 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:
1508923236
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/04/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
129 LAKE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARLINGTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02474-8839
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:
781-648-4823

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
129 LAKE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARLINGTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02474-8839
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-643-8761
Provider Business Practice Location Address Fax Number:
781-648-4823
Provider Enumeration Date:
01/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HILSON
Authorized Official First Name:
JANICE
Authorized Official Middle Name:
F
Authorized Official Title or Position:
CO-ADMINISTRATOR
Authorized Official Telephone Number:
781-643-8761

Provider Taxonomy Codes

  • Taxonomy code: 311ZA0620X , with the licence number:  1344 , 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)





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