Healthcare Provider Details

I. General information

NPI: 1841274511
Provider Name (Legal Business Name): RANDALL A. GUERRA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 MAIN ST
BOXFORD MA
01921-1110
US

IV. Provider business mailing address

PO BOX 305 615 MAIN STREET
WEST BOXFORD MA
01885-0305
US

V. Phone/Fax

Practice location:
  • Phone: 978-352-4840
  • Fax: 978-352-9713
Mailing address:
  • Phone: 978-352-4840
  • Fax: 978-352-9713

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License NumberN/A
License Number StateMA

VIII. Authorized Official

Name: MR. RANDALL A. GUERRA
Title or Position: PRESIDENT
Credential: R.R.T.
Phone: 978-352-4840