MEDICARE: COMMUNITY HEALTH ASSOCIATION OF RICHMOND AND WEST STOCKBRIDGE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417980970
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY HEALTH ASSOCIATION OF RICHMOND AND WEST STOCKBRIDGE

Provider Business Mailing Address
First Line	:	PO BOX 368
Second Line	:	21 STATE LINE RD.
City	:	WEST STOCKBRIDGE
State	:	MA
Zip	:	01266
Country	:	US
Telephone Number	:	413-232-0122
Fax Number	:	413-232-0199

Provider Business Practice Location Address
First Line	:	21 STATE LINE RD.
Second Line	:
City	:	WEST STOCKBRIDGE
State	:	MA
Zip	:	01266
Country	:	US
Telephone Number	:	413-232-0122
Fax Number	:	413-232-0199

Authorized Official
Title or Position	:	DIRECTOR
Name	:	EMILIE JARRETT
Credential	:	RN, BSN
Telephone Number	:	413-232-0122

Provider Enumeration Date	:	07/08/2006
Last Update Date	:	10/09/2008

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