1356338529 NPI number — TUFTS MEDICINE CARE AT HOME, INC.

Table of content: (NPI 1356338529)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356338529 NPI number — TUFTS MEDICINE CARE AT HOME, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TUFTS MEDICINE CARE AT HOME, 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:
1356338529
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/19/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
360 MERRIMACK ST STE 425
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAWRENCE
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01843-2165
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-552-4000
Provider Business Mailing Address Fax Number:
978-552-4399

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
360 MERRIMACK ST STE 425
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAWRENCE
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01843-2165
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-552-4000
Provider Business Practice Location Address Fax Number:
978-552-4399
Provider Enumeration Date:
10/04/2005

Additional Information

Authorized Official

Authorized Official Last Name:
O'BRIEN
Authorized Official First Name:
PATRICIA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
978-552-4000

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1939742 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0604542 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2085486 . This is a "AETNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 99809301 . This is a "NETWORK HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0017922 . This is a "NEIGHBORHOOD HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 221508 . This is a "BLUE CROSS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 6555 . This is a "FALLON" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 110024339A , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 221508 . This is a "ANTHEM BLUE CROSS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 701981 . This is a "HARVARD PILGRIM HEALTH CA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 801524 . This is a "TUFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 3086592 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".




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