Healthcare Provider Details

I. General information

NPI: 1922841477
Provider Name (Legal Business Name): FOOD BANK OF WESTERN MASSACHUSETTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2024
Last Update Date: 06/13/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 CAREW ST
CHICOPEE MA
01020-4503
US

IV. Provider business mailing address

25 CAREW ST
CHICOPEE MA
01020-4503
US

V. Phone/Fax

Practice location:
  • Phone: 413-247-9738
  • Fax:
Mailing address:
  • Phone: 413-247-9738
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINA MAXWELL
Title or Position: DIRECTOR OF PROGRAMS
Credential:
Phone: 413-247-9738