1649217555 NPI number — BAYSTATE HEALTH SYSTEM AMBULANCE, INC

Table of content: (NPI 1649217555)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649217555 NPI number — BAYSTATE HEALTH SYSTEM AMBULANCE, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BAYSTATE HEALTH SYSTEM AMBULANCE, 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:
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:
1649217555
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3799
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BOSTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02241-3799
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
413-773-4500
Provider Business Mailing Address Fax Number:
413-773-4584

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
338 HIGH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENFIELD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01301-2611
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-773-4500
Provider Business Practice Location Address Fax Number:
413-773-4584
Provider Enumeration Date:
05/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SIMONDS
Authorized Official First Name:
BRIAN
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
413-774-3051

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  3373 , 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: 091159 . This is a "CIGNA BEHAVIORAL HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1714082 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 702152 . This is a "HARVARD PILGRAM HP" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 091159 . This is a "CONNECTICARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 33 . This is a "HAMPSHIRE CNTY HSE OF COR" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1005380 . This is a "BEACON HEALTH STRATEGIES" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1005380 . This is a "BMC HEALTHNET PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 801640 . This is a "TUFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 9207234 . This is a "CIGNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 99606601 . This is a "NETWORK HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0009940 . This is a "NEIGHBORHOOD HP" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 091159 . This is a "BC/BS OF MASS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1000228 . This is a "VERMONT MEDICAID" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".




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