1851475339 NPI number — KEVIN SNOW D.O., LLC

Table of content: DR. MEREDITH ELAINE AUSTIN DO (NPI 1427286400)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851475339 NPI number — KEVIN SNOW D.O., LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KEVIN SNOW D.O., LLC
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:
1851475339
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:
PO BOX 489
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EAST LONGMEADOW
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01028-0489
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
413-525-9445
Provider Business Mailing Address Fax Number:
413-525-9406

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10 HOSPITAL DR
Provider Second Line Business Practice Location Address:
SUITE 305
Provider Business Practice Location Address City Name:
HOLYOKE
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01040-6603
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-533-2452
Provider Business Practice Location Address Fax Number:
413-533-3624
Provider Enumeration Date:
10/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SNOW
Authorized Official First Name:
KEVIN
Authorized Official Middle Name:
Authorized Official Title or Position:
PHYSICIAN/OWNER
Authorized Official Telephone Number:
413-533-2452

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  MA213952 , 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: M18771 . This is a "BLUE CROSS OF MASSACHUSET" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com