Healthcare Provider Details

I. General information

NPI: 1104019215
Provider Name (Legal Business Name): HOLYOKE MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2007
Last Update Date: 06/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 BEECH ST
HOLYOKE MA
01040-2223
US

IV. Provider business mailing address

575 BEECH ST
HOLYOKE MA
01040-2223
US

V. Phone/Fax

Practice location:
  • Phone: 413-534-2805
  • Fax: 413-534-2752
Mailing address:
  • Phone: 413-534-2805
  • Fax: 413-534-2752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number2145
License Number StateMA

VIII. Authorized Official

Name: MR. PAUL M. SILVA
Title or Position: VICE PRESIDENT OF FINANCE
Credential:
Phone: 413-534-2567