1528404175 NPI number — BAY STATE COMMUNITY HEALTHCARE

Table of content: MRS. JOANNE KELLY BARRIENTES LVN (NPI 1295970218)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528404175 NPI number — BAY STATE COMMUNITY HEALTHCARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BAY STATE COMMUNITY HEALTHCARE
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:
1528404175
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/21/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 390002
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAMBRIDGE
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02139-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-996-0630
Provider Business Mailing Address Fax Number:
781-558-5466

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
34 GUILD RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRAMINGHAM
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01702-8713
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-996-0630
Provider Business Practice Location Address Fax Number:
781-558-5466
Provider Enumeration Date:
05/21/2013

Additional Information

Authorized Official

Authorized Official Last Name:
PASCUAL
Authorized Official First Name:
GLORIA
Authorized Official Middle Name:
Authorized Official Title or Position:
FOUNDER/CEO
Authorized Official Telephone Number:
508-283-0564

Provider Taxonomy Codes

  • Taxonomy code: 253J00000X , 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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