Healthcare Provider Details

I. General information

NPI: 1497115778
Provider Name (Legal Business Name): JOSEPH MUCHAI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2016
Last Update Date: 01/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

82 MIDDLESEX ST
N CHELMSFORD MA
01863-1519
US

IV. Provider business mailing address

82 MIDDLESEX ST
N CHELMSFORD MA
01863-1519
US

V. Phone/Fax

Practice location:
  • Phone: 978-601-6421
  • Fax: 978-677-6125
Mailing address:
  • Phone: 978-601-6421
  • Fax: 978-677-6125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberS09581593
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License NumberS09581593
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License NumberS09581593
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License NumberS09581593
License Number StateMA
# 5
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNULL
# 6
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License NumberS09581593
License Number StateMA
# 7
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number StateNULL
# 8
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License NumberS09581593
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: