1558674135 NPI number — ATLANTIC NURSING AND HOMECARE, INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558674135 NPI number — ATLANTIC NURSING AND HOMECARE, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ATLANTIC NURSING AND HOMECARE, 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:
1558674135
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/23/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
73 HOLBROOK AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRAINTREE
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02184-6506
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
781-864-3406
Provider Business Mailing Address Fax Number:
781-848-3473

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
73 HOLBROOK AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRAINTREE
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02184-6506
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-864-3406
Provider Business Practice Location Address Fax Number:
781-848-3473
Provider Enumeration Date:
07/23/2010

Additional Information

Authorized Official

Authorized Official Last Name:
GUTHRIE
Authorized Official First Name:
NANCY
Authorized Official Middle Name:
ELINOR
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
781-864-3406

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  7478 , 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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