Healthcare Provider Details

I. General information

NPI: 1346538972
Provider Name (Legal Business Name): PINGRY HILL ENTERPRISES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2011
Last Update Date: 07/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 STOW RD UNIT A
BOXBOROUGH MA
01719-1845
US

IV. Provider business mailing address

PO BOX 721
CONCORD MA
01742-0721
US

V. Phone/Fax

Practice location:
  • Phone: 978-631-0800
  • Fax:
Mailing address:
  • Phone: 978-235-1910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. BARBARA J MACK
Title or Position: PRESIDENT
Credential: MPA
Phone: 978-235-1910