Healthcare Provider Details

I. General information

NPI: 1558307413
Provider Name (Legal Business Name): SARAH BRAYTON GENERAL PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 06/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4901 N MAIN ST
FALL RIVER MA
02720-2080
US

IV. Provider business mailing address

101 E STATE ST
KENNETT SQUARE PA
19348-3109
US

V. Phone/Fax

Practice location:
  • Phone: 508-675-1001
  • Fax: 508-675-7088
Mailing address:
  • Phone: 610-925-4436
  • Fax: 610-925-4351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0951
License Number StateMA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier904781
Identifier TypeOTHER
Identifier State
Identifier IssuerHARVARD PILGRIM
# 2
Identifier551896
Identifier TypeOTHER
Identifier State
Identifier IssuerAETNA-HMO
# 3
Identifier000000021572
Identifier TypeOTHER
Identifier State
Identifier IssuerBOSTON MEDICAL CENTER
# 4
Identifier0940283
Identifier TypeMEDICAID
Identifier StateMA
Identifier Issuer
# 5
Identifier71-01006
Identifier TypeOTHER
Identifier State
Identifier IssuerUNITED HEALTH CARE
# 6
Identifier2222558910
Identifier TypeOTHER
Identifier StateMA
Identifier IssuerBC/BS - OUTPATIENT REHAB
# 7
Identifier2222558901
Identifier TypeOTHER
Identifier State
Identifier IssuerBC/BS OF MA

VIII. Authorized Official

Name: JANE DROPESKEY
Title or Position: CORPORATE MANAGER
Credential:
Phone: 610-925-4231