Healthcare Provider Details

I. General information

NPI: 1588922512
Provider Name (Legal Business Name): SPECTRUM HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2012
Last Update Date: 05/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

68 FRANKLIN ST
FRAMINGHAM MA
01702-6671
US

IV. Provider business mailing address

68 FRANKLIN ST
FRAMINGHAM MA
01702-6671
US

V. Phone/Fax

Practice location:
  • Phone: 508-875-5801
  • Fax: 508-872-8934
Mailing address:
  • Phone: 508-875-5801
  • Fax: 508-872-8934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: PATRICIA A GREENE DAY
Title or Position: CLINIC OFFICE COORDINATOR
Credential:
Phone: 508-875-5801