1659522027 NPI number — CARITAS VALLEY REGIONAL SUPPORT SERVICES INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659522027 NPI number — CARITAS VALLEY REGIONAL SUPPORT SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARITAS VALLEY REGIONAL SUPPORT SERVICES 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:
1659522027
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/21/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
70 EAST ST
Provider Second Line Business Mailing Address:
ATTN: MARTHA MCDRURY
Provider Business Mailing Address City Name:
METHUEN
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01844-4597
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-687-0156
Provider Business Mailing Address Fax Number:
978-685-9132

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
70 EAST ST
Provider Second Line Business Practice Location Address:
RADIOLOGY DEPARTMENT
Provider Business Practice Location Address City Name:
METHUEN
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01844-4597
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-687-0156
Provider Business Practice Location Address Fax Number:
978-685-9132
Provider Enumeration Date:
10/03/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MCDRURY
Authorized Official First Name:
MARTHA
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF OPERATING OFFICER
Authorized Official Telephone Number:
978-687-0156

Provider Taxonomy Codes

  • Taxonomy code: 207U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RX0202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RH0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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