1487626644 NPI number — NEW ENGLAND MOBILE X-RAY, INC.

Table of content: (NPI 1487626644)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487626644 NPI number — NEW ENGLAND MOBILE X-RAY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW ENGLAND MOBILE X-RAY, 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:
1487626644
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/16/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3 CABOT PL
Provider Second Line Business Mailing Address:
UNIT 9
Provider Business Mailing Address City Name:
STOUGHTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02072-4612
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-636-9729
Provider Business Mailing Address Fax Number:
781-341-0053

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3 CABOT PL
Provider Second Line Business Practice Location Address:
UNIT 9
Provider Business Practice Location Address City Name:
STOUGHTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02072-4612
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-636-9729
Provider Business Practice Location Address Fax Number:
781-341-0053
Provider Enumeration Date:
02/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SMITH
Authorized Official First Name:
ALLAN
Authorized Official Middle Name:
E
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
800-636-9729

Provider Taxonomy Codes

  • Taxonomy code: 261QR0208X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000000021174 . This is a "BMC HEALTH NET" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0008714 . This is a "NEIGHBORHOOD HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 601560 . This is a "FIRST SENIORITY HARVARD P" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 765145 . This is a "CONNECTICARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 0000021552 . This is a "BCBS RI" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 100369 . This is a "BCBS ME" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: M13745 . This is a "MEDEX" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1598406 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: M13745 . This is a "BCBS MA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0090174 . This is a "HEALTHY START" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 30007444 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".




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