1891805230 NPI number — WAREHAM ORTHOPEDIC ASSOCIATES INCORPORATED

Table of content: (NPI 1891805230)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891805230 NPI number — WAREHAM ORTHOPEDIC ASSOCIATES INCORPORATED

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WAREHAM ORTHOPEDIC ASSOCIATES INCORPORATED
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:
1891805230
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/07/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 RECOVERY RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WAREHAM
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02571-5011
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-295-5100
Provider Business Mailing Address Fax Number:
508-295-9467

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 RECOVERY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WAREHAM
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02571-5011
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-295-5100
Provider Business Practice Location Address Fax Number:
508-295-9467
Provider Enumeration Date:
08/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ENOS
Authorized Official First Name:
NANCY
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
508-295-5100

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X , 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: 000000023730 . This is a "BOSTON MEDICAL CENTER HEA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0500541 . This is a "AETNA/USHEALTHCARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 702215 . This is a "TUFTS HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: CL8462 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: M12839 . This is a "BCBS OF MASSACHUSETTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 600657 . This is a "HARVARD PILGRIM HEALTHCAR" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 9716343 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".




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