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NPI Code Detail

MEDICARE: COMMONWEALTH OF MASSACHUSETTS

MEDICARE: COMMONWEALTH OF MASSACHUSETTS
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
1251B00000XCase Management Agency

Other Identifiers

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

General Provider Information

NPI Number : 1811014905
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMONWEALTH OF MASSACHUSETTS
Provider Business Mailing Address
First Line : 391 VARNUM AVE
Second Line :
City : LOWELL
State : MA
Zip : 01854-2119
Country : US
Telephone Number : 978-322-5000
Fax Number :
Provider Business Practice Location Address
First Line : 391 VARNUM AVE
Second Line :
City : LOWELL
State : MA
Zip : 01854-2119
Country : US
Telephone Number : 978-322-5000
Fax Number :
Authorized Official
Title or Position : SITE DIRECTOR
Name : JOHN GILMORE
Credential :
Telephone Number : 978-322-5000
Provider Enumeration Date : 03/23/2007
Last Update Date : 08/22/2020

Similar Medicare Providers

1306774898 — AYUSHEE PATEL
Practice Location Address:
391 VARNUM AVE
LOWELL, MA
01854-2119
Practice Phone: 978-674-6744
Practice Fax:
1326005836 — TIMAREE CATHERINE BROWN PMHNP-BC
Practice Location Address:
391 VARNUM AVE
LOWELL, MA
01854-2119
Practice Phone: 978-703-2212
Practice Fax: 978-703-2490
1558465187 — DARREN E. NORDIN LICSW
Practice Location Address:
391 VARNUM AVE
LOWELL, MA
01854-2119
Practice Phone: 978-322-5120
Practice Fax:
1114025889 — MS. ELIZABETH BAMFORD FLYNN ARNP
Practice Location Address:
391 VARNUM AVE
LOWELL, MA
01854-2119
Practice Phone: 978-322-5183
Practice Fax:
1073674420 — CHOATE HEALTH MANAGEMENT
Practice Location Address:
391 VARNUM AVE
LOWELL, MA
01854-2119
Practice Phone: 978-322-5120
Practice Fax:
1144360181 — MRS. CARISA DAWN PAJAK MSW
Practice Location Address:
391 VARNUM AVE , 2ND FLOOR
LOWELL, MA
01854-2119
Practice Phone: 800-727-6324
Practice Fax:

Directions to “COMMONWEALTH OF MASSACHUSETTS ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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