1386809978 NPI number — THE CATARACT SURGERY CENTER OF MILFORD, INC.

Table of content: (NPI 1386809978)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386809978 NPI number — THE CATARACT SURGERY CENTER OF MILFORD, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE CATARACT SURGERY CENTER OF MILFORD, 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:
1386809978
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/23/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
145 WEST ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MILFORD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01757-2226
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-381-5600
Provider Business Mailing Address Fax Number:
508-381-5610

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
145 WEST ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MILFORD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01757-2226
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-381-5600
Provider Business Practice Location Address Fax Number:
508-381-5610
Provider Enumeration Date:
07/23/2008

Additional Information

Authorized Official

Authorized Official Last Name:
GOODMAN
Authorized Official First Name:
GLEN
Authorized Official Middle Name:
K.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
508-381-5600

Provider Taxonomy Codes

  • Taxonomy code: 261QS0132X , 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: 0802000 . This is a "UNITED HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 260645939 . This is a "MULTIPLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 59494 . This is a "DAVIS VISION EYE EXAM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 97627805 . This is a "NETWORK HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1043218159 . This is a "FALLON" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 9708341 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 700730 . This is a "TUFTS" identifier . This identifiers is of the category "OTHER".
  • Identifier: C20273 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0041608 . This is a "CIGNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0802000 . This is a "EVERCARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1536374 . This is a "FOCUS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 260645939 . This is a "NORTH AMERICAN PREFFERED" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1043218159 . This is a "TRICARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 15872 . This is a "HARVARD PILGRIM HEALTH CARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 204465 . This is a "DAVIS VISION LASERS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 00000280 . This is a "NEIGHBORHOOD HEALTH CARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 260645939 . This is a "GREAT WEST HEALTH CARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1043218159 . This is a "UNICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4263773 . This is a "AETNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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