Healthcare Provider Details
I. General information
NPI: 1033701560
Provider Name (Legal Business Name): MOUNTAIN HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/05/2021
Last Update Date: 02/26/2026
Certification Date: 02/26/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
67 UNION ST STE 401
NATICK MA
01760-7700
US
IV. Provider business mailing address
67 UNION ST STE 401
NATICK MA
01760-7700
US
V. Phone/Fax
- Phone: 617-206-2090
- Fax: 855-829-6228
- Phone: 617-206-2090
- Fax: 855-829-6228
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1835P0018X |
| Taxonomy | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SARAH
SHI
Title or Position: MANAGER
Credential:
Phone: 617-206-2090