Healthcare Provider Details

I. General information

NPI: 1730421207
Provider Name (Legal Business Name): SURRIMASSINI, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2013
Last Update Date: 03/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1907 BROUGHTON DR
BEVERLY MA
01915-1855
US

IV. Provider business mailing address

1907 BROUGHTON DR
BEVERLY MA
01915-1855
US

V. Phone/Fax

Practice location:
  • Phone: 978-335-3462
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347B00000X
TaxonomyBus
License Number
License Number State

VIII. Authorized Official

Name: MR. SUREN MASUMYAN
Title or Position: PRESIDENT
Credential:
Phone: 857-499-4944