Healthcare Provider Details

I. General information

NPI: 1326018011
Provider Name (Legal Business Name): JIM PREVETT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 03/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129 MANOMET AVE
HULL MA
02045-2128
US

IV. Provider business mailing address

129 MANOMET AVE
HULL MA
02045-2128
US

V. Phone/Fax

Practice location:
  • Phone: 781-925-9493
  • Fax: 781-925-1203
Mailing address:
  • Phone: 781-925-9493
  • Fax: 781-925-1203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: JAMES PREVETT
Title or Position: OWNER
Credential:
Phone: 781-925-9493