1235301797 NPI number — BRN CORPORATION

Table of content: (NPI 1235301797)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235301797 NPI number — BRN CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BRN CORPORATION
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:
6
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:
1235301797
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/21/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
25 RAILROAD SQ
Provider Second Line Business Mailing Address:
SUITE 503
Provider Business Mailing Address City Name:
HAVERHILL
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01832-5721
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-556-5907
Provider Business Mailing Address Fax Number:
978-521-8818

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
145 WARD HILL AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRADFORD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01835-6928
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-372-8000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/25/2008

Additional Information

Authorized Official

Authorized Official Last Name:
ARCIDI
Authorized Official First Name:
ALFRED
Authorized Official Middle Name:
J
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
978-556-5858

Provider Taxonomy Codes

  • Taxonomy code: 282E00000X , with the licence number:  2292 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 283X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 38900 . This is a "CIGNA/HEALTHSOURCE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0009417 . This is a "NEIGHBORHOOD HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0081090 . This is a "AETNA/US HEALTHCARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 110078934B , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2222203410 . This is a "BLUE CROSS (OUTPATIENT)" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 2222203401 . This is a "BLUE CROSS (INPATIENT)" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5280218 . This is a "EVERCARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 907586 . This is a "TUFTS ASSOC HEALTH PLAN (OUTPATIENT)" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 96031 . This is a "CIGNA/HEALTHSOURCE(OUTPATIENT)" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 982299 . This is a "TUFTS ASSOC HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 110078934C , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: AA115113 . This is a "HARVARD PILGRIM HEALTHCARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 2222203402 . This is a "BLUE CROSS IP LEV 2" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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